Case report

A case of chronic myelomonocytic leukemia complicated with immune thrombocytopenia

  • Jiayu LIU ,
  • Fang HUANG ,
  • Siguo HAO
Expand
  • Department of Hematology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200082, China
HAO Siguo, E-mail: haosiguo@xinhuamed.com.cn.
HUANG Fang, E-mail: huangfang335@163.com

Received date: 2023-10-09

  Accepted date: 2023-12-07

  Online published: 2024-02-28

Abstract

Chronic myelomonocytic leukemia (CMML) complicated with immune thrombocytopenia (ITP) is rare. This article reports the clinical data of a patient with CMML complicated with ITP treated with a combination of venetoclax, ripertamab (an anti-CD20 monoclonal antibody), and hetrombopag. The coexistence mechanism of CMML and ITP needs to be further clarified. Venetoclax combined with anti-CD20 monoclonal antibody and thrombopoietin receptor agonist may be an effective strategy for the treatment of this complication.

Cite this article

Jiayu LIU , Fang HUANG , Siguo HAO . A case of chronic myelomonocytic leukemia complicated with immune thrombocytopenia[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2024 , 44(2) : 287 -290 . DOI: 10.3969/j.issn.1674-8115.2024.02.016

References

1 GIANNOULI S, TZOANOPOULOS D, RITIS K, et al. Autoimmune manifestations in human myelodysplasia: a positive correlation with interferon regulatory factor-1 (IRF-1) expression[J]. Ann Rheum Dis, 2004, 63(5): 578-582.
2 KHOURY J D, SOLARY E, ABLA O, et al. The 5th edition of the World Health Organization Classification of Haematolymphoid Tumours: myeloid and Histiocytic/Dendritic Neoplasms[J]. Leukemia, 2022, 36(7): 1703-1719.
3 ELENA C, GALLì A, SUCH E, et al. Integrating clinical features and genetic lesions in the risk assessment of patients with chronic myelomonocytic leukemia[J]. Blood, 2016, 128(10): 1408-1417.
4 SAVONA M R, MALCOVATI L, KOMROKJI R, et al. An international consortium proposal of uniform response criteria for myelodysplastic/myeloproliferative neoplasms (MDS/MPN) in adults[J]. Blood, 2015, 125(12): 1857-1865.
5 中华医学会血液学分会白血病淋巴瘤学组. 慢性粒-单核细胞白血病诊断与治疗中国指南(2021年版)[J]. 中华血液学杂志, 2021, 42(1): 5-9.
5 Leukemia and Lymphoma Group, Chinese Society of Hematology, Chinese Medical Association. Guideline of the diagnosis and treatment of chronic myelomonocytic leukemia (2021 edition)[J]. Chinese Journal of Hematology, 2021, 42(1): 5-9.
6 COLTRO G, MANGAONKAR A A, LASHO T L, et al. Clinical, molecular, and prognostic correlates of number, type, and functional localization of TET2 mutations in chronic myelomonocytic leukemia (CMML)-a study of 1084 patients[J]. Leukemia, 2020, 34(5): 1407-1421.
7 BOURGEOIS E, CAULIER M T, ROSE C, et al. Role of splenectomy in the treatment of myelodysplastic syndromes with peripheral thrombocytopenia: a report on six cases[J]. Leukemia, 2001, 15(6): 950-953.
8 MAINWARING C J, SHUTT J, JAMES C M. Not all cases of idiopathic thrombocytopenic purpura [correction of pupura] are what they might first seem[J]. Clin Lab Haematol, 2002, 24(4): 261-262.
9 FUKUDA M, HORIBE K, MIYAJIMA Y, et al. Chronic myelomonocytic leukemia developed 9 years after the diagnosis of idiopathic thrombocytopenic purpura in a child[J]. Rinsho Ketsueki, 1994, 35(6): 609-615.
10 HADJADJ J, MICHEL M, CHAUVEHEID M P, et al. Immune thrombocytopenia in chronic myelomonocytic leukemia[J]. Eur J Haematol, 2014, 93(6): 521-526.
11 中华医学会血液学分会血栓与止血学组. 成人原发免疫性血小板减少症诊断与治疗中国指南(2020年版)[J]. 中华血液学杂志,2020,41(8):617-623.
11 Thrombosis and Hemostasis Group, Chinese Society of Hematology, Chinese Medical Association. Chinese guideline on the diagnosis and management of adult primary immune thrombocytopenia (version 2020)[J]. Chinese Journal of Hematology, 2020, 41(8): 617-623.
12 束新辉. 大剂量地塞米松联合小剂量利妥昔单抗治疗免疫性血小板减少症的疗效和相关因素分析[D]. 郑州: 郑州大学, 2019.
12 SHU X H. Efficacy of related factors of high-dose dexamethasone combined with low-dose rituximab in the treatment of immune thrombocytopenia[D]. Zhengzhou: Zhengzhou University, 2019.
13 叶少杰, 徐建梅, 郭慧梅, 等. 维奈克拉联合阿扎胞苷治疗初诊慢性粒单核细胞白血病2型4例并文献复习[J]. 白血病·淋巴瘤, 2023, 32(11): 667-670.
13 YE S J, XU J M, GUO H M, et al. Veneckla combined with azacytidine in the treatment of newly diagnosed chronic monocytic leukemia-2: report of 4 cases and review of literature[J]. Journal of Leukemia and Lymphoma, 2023, 32(11): 667-670.
14 SHORT N J, MUFTUOGLU M, ONG F, et al. A phase 1/2 study of azacitidine, venetoclax and pevonedistat in newly diagnosed secondary AML and in MDS or CMML after failure of hypomethylating agents[J]. J Hematol Oncol, 2023, 16(1): 73.
15 HAMMOND D, DINARDO C D, KONOPLEVA M, et al. Activity of venetoclax-based therapy in CMML and CMML with blast transformation[J]. Blood, 2020, 136(Supplement 1): 36-37.
Outlines

/