Autoimmune thrombocytopenia: A complication of fludarabine therapy in lymphoproliferative disorders

We describe two cases of autoimmune thrombocytopenia precipitated by fludar abine therapy in patients with chronic lymphatic leukaemia. Both were treat ed with high dose steroids and initially responded with recovery of normal platelet counts. One patient developed recurrent autoimmune thrombocytopeni a on two occasions following re-exposure to the drug when his disease had b ecome refractory to all other treatments. A retrospective review of the cas e notes of 45 patients with lymphoproliferative disorders treated with flud arabine over the past 6 years indicated the development of autoimmune throm bocytopenia in 4.5% (two out of 45) and autoimmune haemolytic anaemia in 6. 7% (three of the 45).