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J Clin Pathol 2009;62:468-470 doi:10.1136/jcp.2008.061143
  • Case report

Autoimmune pancytopenia following combination chemotherapy for chronic lymphocytic leukaemia

  1. S MacCallum1,
  2. M Groves1,
  3. D Brass2,
  4. J Cunningham3,
  5. M Sales3,
  6. K Gelly3,
  7. S Tauro1
  1. 1
    Centre for Oncology and Molecular Medicine, Division of Medical Sciences, University of Dundee, Dundee, Scotland, UK
  2. 2
    Department of Haematology, Ninewells Hospital and Medical School, Dundee, Scotland, UK
  3. 3
    Department of Cytogenetics, Ninewells Hospital and Medical School, Dundee, Scotland, UK
  1. Dr Sudhir Tauro, Division of Pathology and Neuroscience, Ninewells Hospital and Medical School, Dundee DD1 9SY, Scotland, UK; s.tauro{at}dundee.ac.uk
  • Accepted 22 October 2008

Abstract

Autoimmune haemolysis or thrombocytopenia can complicate purine nucleoside monotherapy for chronic lymphocytic leukaemia (CLL), but Evans syndrome is rare. This is a report of the occurrence of pancytopenia secondary to a unique combination of red cell aplasia with autoimmune thrombocytopenia and neutropenia in a patient with CLL following treatment with fludarabine and cyclophosphamide. This case is unusual for the simultaneous targeting of three haemopoietic lineages by immune dysfunction following fludarabine and cyclophosphamide, which is a treatment regimen believed to reduce autoimmune haematological toxicity in CLL.

Footnotes

  • Competing interests: None.

  • Patient consent: Obtained.

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