Efficacy of rituximab in the treatment of refractory chronic lymphocytic leukemia patient with bone marrow aplasia.

Recently, several reports have been published claiming the efficacy of anti-CD20 monoclonal antibody (rituximab) in the treatment of B-cell chronic lymphocytic leukemia (B-CLL) and some related autoimmune complications. We used anti-CD20 monoclonal antibody in a patient with advanced stage and heavily pre-treated B-CLL with a concomitant bone marrow aplasia requiring a remarkable transfusional support of both red blood cells and platelets. The treatment was conducted according to standard dosage and schedule and the patient did not experience any severe side effect. A progressive reduction of transfusions and a certain recovery of bone marrow cellularity was observed after six months from the end of therapy. This case suggests that rituximab can play a role in this subset of B-CLL patients with very few effective therapeutic options and in which the clinical features may be due both to neoplastic proliferation and concomitant autoimmune disorder.