Immune Thrombocytopenia in a Child with T Cell Lymphoblastic Lymphoma

Tokeji, Kayo; Sakaguchi, Sachi; Kurimoto, Tomoko; Fujimura, Junya; Shimizu, Toshiaki

doi:10.1155/2016/2897325

Cited by 3 publications

(5 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Immune thrombocytopenic purpura is known to develop secondary to lymphoproliferative disorders. 14,15 Thus, the underlying HSTL may be causing direct and indirect platelet dysfunction which manifests as purpuric eruptions in sunexposed sites.…”

Section: Discussionmentioning

confidence: 99%

“…We postulate the etiology of the purpuric reactions in this patient group is a result of a combination of the effect of skin fragility due to sun exposure combined with the underlying effect of the T-cell lymphoma on platelet counts. Immune thrombocytopenic purpura is known to develop secondary to lymphoproliferative disorders 14,15. Thus, the underlying HSTL may be causing direct and indirect platelet dysfunction which manifests as purpuric eruptions in sun-exposed sites.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Capillaritis as a Skin Manifestation of Hepatosplenic Gamma-Delta T-Cell Lymphoma

Jakharia-Shah¹,

Ho²,

Lolatgis³

et al. 2021

Journal of Pediatric Hematology/Oncology

View full text Add to dashboard Cite

We present the case of a 10-year-old boy who was admitted with 3 months of episodic febrile neutropenia and a new petechial rash. Routine bloods identified neutropenia, thrombocytopenia, and a raised alanine aminotransferase. The dermatology team was consulted in light of the symmetrical petechial eruption of the upper torso. A punch biopsy of the lesion was consistent with early capillaritis. The results showed superficial dermal red blood cell extravasation with mild perivascular lymphohistiocytic inflammatory infiltrate. There was no evidence of an atypical lymphoid infiltrate in the skin biopsy. An initial bone marrow aspirate showed an abnormal mature T-cell population consisting of CD4 and CD8 T cells with gamma-delta positivity. Karyotyping was also done, which demonstrated isochromosome 7q. These findings were consistent with a diagnosis of hepatosplenic T-cell lymphoma (HSTL). The patient underwent fourth-line chemotherapy due to refractory relapsing disease but sadly passed away within 12 months of diagnosis. HSTL is a rare and aggressive subset of peripheral T-cell lymphoma. Prognosis is poor with a median survival of < 1 year from diagnosis. However, reports suggest improved outcomes if intensive, early, highdose chemotherapy is used alongside hematopoietic stem cell transplantation. Therefore, there is an impetus to attain early diagnosis for aggressive early treatment and improved patient outcomes. Capillaritis, presenting as asymptomatic nonpalpable purpura, can be a rare presenting feature of HSTL. Dermatologists could play a pivotal role in the early recognition of this rare but aggressive hematological malignancy and promote prompt treatment resulting in better patient outcomes.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Capillaritis as a Skin Manifestation of Hepatosplenic Gamma-Delta T-Cell Lymphoma

Jakharia-Shah¹,

Ho²,

Lolatgis³

et al. 2021

Journal of Pediatric Hematology/Oncology

View full text Add to dashboard Cite

show abstract

“…We report here an interesting association of chronic ITP with the development of T-lymphoblastic lymphoma in a child. In a literature search, we identified very few reported cases of concurrent ITP and T-cell malignancies in children and even fewer cases in which chronic ITP preceded the development of lymphoma or leukemia [13][14][15][16]. In one such case, a 13-month-old otherwise asymptomatic boy was found to be thrombocytopenic on routine blood work and 10 months later developed a large facial and periorbital hematoma after head trauma [15].…”

Section: Discussionmentioning

confidence: 99%

Association of Immune Thrombocytopenia and T-Lymphoblastic Lymphoma in a Pediatric Patient

Denu

Matson

Davis

et al. 2019

Case Reports in Hematology

View full text Add to dashboard Cite

Immune thrombocytopenia (ITP) is characterized by isolated thrombocytopenia of unclear etiology. We present a unique case of an 8-year-old girl with chronic ITP who was subsequently diagnosed with T-lymphoblastic lymphoma at age 11. The clinical course was complicated by the occurrence of nonepileptiform events with bizarre behavior changes following the administration of nelarabine and intrathecal and high-dose systemic methotrexate. This case highlights an unusual co-occurrence of hematologic malignancy and chronic ITP in an otherwise healthy child. We speculate that underlying genetic or immunologic lesions may predispose a subset of pediatric ITP patients to the development of hematologic malignancies.

show abstract

“…Standard first-line therapies for ITP remain corticosteroids and IVIG 3. A previous case report describes persistent thrombocytopenia responding to immunoglobulin and steroids in a 13-year-old male patient with T cell lymphoblastic lymphoma on methotrexate and mercaptopurine 1. Another case report describes chronic ITP in a 7-year-old patient with ALL undergoing early intensification therapy 2.…”

Section: Discussionmentioning

confidence: 99%

“…ITP has been associated with haematological malignancies like chronic lymphocytic leukaemia, Hodgkin’s lymphoma and non-Hodgkin’s lymphoma 1. However, the presence of ITP in children with acute lymphoblastic leukaemia (ALL) is rare and not well described in the literature 2…”

Section: Introductionmentioning

confidence: 99%

Treatment of immune thrombocytopenic purpura associated with cytomegalovirus infection in a child with pre-B cell acute lymphoblastic leukaemia after central nervous system relapse

Martinez

Paul

Kuo³

2017

BMJ Case Reports

View full text Add to dashboard Cite

A 13-year-old male patient with a history of pre-B cell acute lymphoblastic leukaemia (ALL) with isolated central nervous system relapse on maintenance chemotherapy presented with severe thrombocytopenia refractory to platelet transfusions. The patient showed only modest responses to two courses of intravenous immunoglobulin and steroids. He was found to be positive for cytomegalovirus (CMV) with modest viral load. His thrombocytopenia normalised with rituximab therapy and CMV treatment supporting the diagnosis of CMV-associated immune thrombocytopenic purpura (ITP). Following treatment, the patient continued to have a stable platelet count well above the threshold for transfusions. He continued to be intermittently treated for CMV when viral loads became detectable. This report discusses the unique management considerations of ITP in a patient undergoing therapy for ALL with a review of previously reported cases and discusses the possibility of CMV viraemia as a modulating factor.

show abstract

Immune Thrombocytopenia in a Child with T Cell Lymphoblastic Lymphoma

Cited by 3 publications

References 5 publications

Capillaritis as a Skin Manifestation of Hepatosplenic Gamma-Delta T-Cell Lymphoma

Capillaritis as a Skin Manifestation of Hepatosplenic Gamma-Delta T-Cell Lymphoma

Association of Immune Thrombocytopenia and T-Lymphoblastic Lymphoma in a Pediatric Patient

Treatment of immune thrombocytopenic purpura associated with cytomegalovirus infection in a child with pre-B cell acute lymphoblastic leukaemia after central nervous system relapse

Contact Info

Product

Resources

About