Strategies for Managing Immune Thrombocytopenia in CLL

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Immune thrombocytopenia (ITP) is one of the most challenging comorbidities that can be diagnosed in patients with chronic lymphocytic leukemia (CLL), suggests John C. Byrd, MD. The classic strategy for managing ITP involves the administration of steroids. Studies are looking at novel approaches such as rituximab, which aims to control ITP and reduce the need for steroids.

Treatment with rituximab induces long-lasting responses in approximately 30% of patients with chronic ITP. Since rituximab does not work all of the time, Thomas J. Kipps, MD, suggests splenectomy may be another treatment option for patients with CLL and life-threatening ITP or autoimmune hemolytic anemia.

In some situations, ITP or autoimmune hemolytic anemia may improve when patients respond to treatment for CLL, Byrd and Shuo Ma, MD, PhD, explain. A study presented at the ASH Annual Meeting, suggested that treatment-emergent autoimmune cytopenias were rare and not connected with ibrutinib. Additionally, ibrutinib was found to support the tapering of therapies for cytopenias.