Rituximab-Induced Acute Severe Thrombocytopenia: A Case Series in Patients With Mantle Cell Lymphoma

Sadashiv, Santhosh; Rao, Rohit; Fazal, Salman; Lister, John

doi:10.1016/j.clml.2013.04.013

Cited by 12 publications

(14 citation statements)

References 20 publications

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“…Clinically evident cytokine-release syndrome was commonly found, occurring in 14 cases (absent in five; not reported on in the remainder), and with similar manifestations to that presented in our case, including fever, chills, severe rigors and tachycardia, but without profound hypotension except in one case where the reaction was severe 19. Postinfusion thrombocytopenia was documented in all cases reviewed (mean preinfusion level of 116 000+/−38 581, and postinfusion level of 22 379+/−18 076).…”

Section: Discussionsupporting

confidence: 83%

Disseminated intravascular coagulation-like reaction following rituximab infusion

Rafei¹,

Nassereddine

García

2017

BMJ Case Reports

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Rituximab generally is a well-tolerated medication used in a variety of haematological and autoimmune conditions. The safety profile of the medication has been reviewed in the literature. Infusion reactions due to cytokine release are the most common side effects. With the increased use of rituximab, there is an increase incidence of cytopenias, most commonly thrombocytopenia and leucopenia. Coagulopathy is quite rare, reported previously in four cases in the literature. We highlighted the clinical course of a 39-year-old patient with precursor B-cell acute lymphoblastic leukaemia who was started on rituximab infusion. The patient developed a cytokine-release syndrome with haemodynamic instability, followed by rapid-onset cytopenias and disseminated intravascular coagulation abnormalities characterised by coagulopathy with fibrinolysis and mucocutaneous bleeding. The report is followed by a review of the literature. It is important to recognise rituximab-induced coagulopathy early as part of the differential diagnosis of thrombocytopenia and disseminated intravascular coagulation following rituximab administration.

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Section: Discussionsupporting

confidence: 83%

Disseminated intravascular coagulation-like reaction following rituximab infusion

Rafei¹,

Nassereddine

García

2017

BMJ Case Reports

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“…A total of 15 such cases have been reported; 13 cases had MCL (6)(7)(8)(9)(10)(11)(12)(13)(14), one small lymphocytic lymphoma (15) and one lymphoplasmacytic lymphoma (16). Therefore, the mechanism of RIAT remains unclear.…”

Section: Discussionmentioning

confidence: 99%

“…Given the low incidence of MCL (-5%) and widespread use of rituximab in various B cell lymphomas, the exclusive occurrence of RIAT in MCL may suggest that MCL-specific clinical and/or pathological features are involved in the pathogenesis of RIAT. RIAT has been frequently associated with infusion-related cytokine release syndrome (6,9,(11)(12)(13)(14) and high tumor burden lymphoma (in the leukemic phase or with massive splenomegaly) (6,(9)(10)(11)(12)(13)(14). It is of interest that RIAT has been also reported in rare cases of hairy cell leukemia (a chronic B-cell lymphoid leukemia) (18) and autoimmune hemolytic anemia (19), in which splenomegaly was observed.…”

Section: Discussionmentioning

confidence: 99%

“…Rituximab-induced acute thrombocytopenia (RIAT) that occurs within a few days of rituximab administration has been rarely reported in patients with NHL (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16). A total of 15 such cases have been reported in the literature.…”

Section: Introductionmentioning

confidence: 99%

“…A total of 15 such cases have been reported in the literature. Interestingly, RIAT has been described almost exclusively in patients with mantle cell lymphoma (MCL) (6)(7)(8)(9)(10)(11)(12)(13)(14). MCL is a rare subtype of NHL, accounting for only 5% of NHL cases.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Rituximab-induced Acute Thrombocytopenia in High Tumor Burden Follicular Lymphoma

et al. 2016

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Rituximab-induced acute thrombocytopenia (RIAT), a rare complication of rituximab administration, has not yet been described in follicular lymphoma (FL). A 65-year-old man received rituximab for the treatment of high tumor burden follicular lymphoma in the leukemic phase. The next day, his platelet count abruptly dropped from 85,000 to 5,000/μL, which spontaneously recovered in a few days without specific treatment. We speculate that the occurrence of infusion-related cytokine release syndrome in rituximab-sensitive high tumor burden FL contributed to the development of RIAT. Frequent monitoring of the platelet count is advisable for select patients considered to be at a high risk for RIAT.

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Rituximab-related Severe Toxicity

Ghrénassia

Mariotte

Azoulay

2018

Annual Update in Intensive Care and Emergency Medicine

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Rituximab-Induced Acute Severe Thrombocytopenia: A Case Series in Patients With Mantle Cell Lymphoma

Cited by 12 publications

References 20 publications

Disseminated intravascular coagulation-like reaction following rituximab infusion

Disseminated intravascular coagulation-like reaction following rituximab infusion

Rituximab-induced Acute Thrombocytopenia in High Tumor Burden Follicular Lymphoma

Rituximab-related Severe Toxicity

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