Rituximab in therapy of autoimmune disorders in chronic lymphocytic leukemia.

Autoimmune complications in chronic lymphocytic leukemia are found more frequently than in other lymphoproliferative diseases. The most common of them are: autoimmune hemolytic anemia (AIHA), immune thrombocytopenia (ITP) and partial red cell aplasia. During the last years several reports on successful treatment of these disorders with Rituximab (Mabthera) even in the cases of non-effective steroid and IgG therapy have been made. In our report 5 cases are presented: 2 ANA patients with positive direct Coombs test and high titer of anti-erythrocyte antibodies, and 3 ITP patients with anti-thrombocyte antibodies. In one AIHA patient and in one ITP patient these disorders have developed after combination therapy including Fludarabine. All patients were successfully treated with Mabthera or with combination of Mabthera and COP, some of them after non-effective corticosteroid therapy.