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Topics:
Pediatric Hematology/Oncology • Hematology • Pediatric Hematology • Benign Hematology • ITP • Cytopenia • Neutropenia
What is your preferred strategy for young adults with ITP complicated by recurrent autoimmune neutropenia?
ITP is well controlled on TPO-RA, but AIN which is responsive to steroids recurs despite prior rituximab. Bone marrow biopsy normal and without evidence of large granular lymphocytic leukemia.
Do you consider MMF in addition to TPO-RA versus BTKi?
Answer from: at Community Practice
I appreciate Dr. @Leaf's answer, especially the point that there might be ample marrow reserve. But I would suggest a different take on this question, namely that if one also has autoimmune neutropenia, this isn't "ITP" anymore, but rather multi-lineage immune cytopenias, or Evans syndrome. My gener...
Answer from: at Community Practice
Dr. Robert Evans of Stanford described an association between autoimmune hemolytic anemia and ITP in 1948, and another paper in 1954 added autoimmune neutropenia to the spectrum of Evans syndrome. I have seen a number of such patients where neutropenia is a predominant symptom. For Evans syndrome, I...
These are tough cases as we don’t have a cle...
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I heartily agree that it’s important not to ...