Neutropenia during Revolade treatment in a patient with chronic ITP

01 January 1970 1 7K Report

8-y.o. girl with chronic ITP, ekzema, now 5. relapse, started on Revolade, gradually developed neutropenia. BM normal with lots of Mgc, normal karyotype, trephine biopsy normal. After discontinuing Revolade, slow resolution of neutropenia but deterioration of thrombocytopenia. Currently on prednisone 1mg/kg with clinical improvemrnt, WAS gene mutation pending. Any suggestion regarding diagnosis, treatment? Does anyone familiar with neutropenia during Revolade? Thanks

Jason Cabot

Pulse, high dose dexamethasone and weekly rituximab x 4 would be the preferred first line tx in resistant ITP and can add Revolade if needed to increase platelet count if immunotherapy insufficient.

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