Very long-term remission induced by short-term rituximab monotherapy in a patient with heavily pretreated, chronic immune thrombocytopenic purpura.

The management of patients with refractory immune thrombocytopenic purpura (ITP) may be difficult. We describe a rapid-onset very long-term remission (9 years) induced by short-term rituximab monotherapy in a 62-year-old man with treatment-refractory chronic ITP. Over a 30-year period from the original diagnosis to last follow-up, the patient needed renewed treatment twelve times within the first two decades and was subsequently brought in continuous complete remission for the last decade by a single course of rituximab. The effect of rituximab in ITP has previously been described. However, in chronic, treatment-refractory ITP occurring in elderly patients, remission rates tend to be low and of short duration.

Multiplex PCR for the detection of BCL-1/IGH and BCL-2/IGH gene rearrangements--clinical validation in a prospective study of blood and bone marrow in 258 patients with or suspected of non-Hodgkin's lymphoma.

We have designed a multiplex PCR, which allows for fast and high throughput demonstration of the BCL-1/IGH and BCL-2/IGH fusion DNA observed primarily in mantle cell- and follicular non-Hodgkin's lymphoma (NHL). Blood (PB) and/or bone marrow (BM) from 258 patients suspected of NHL have prospectively been evaluated. Eleven patients (4%) were found t(11;14)+ and 37 patients (14%) t(14;18)+. Comparing these results to standard diagnostic methods of PB and/or BM identified PCR+ samples that were normal by morphology (BCL-1/IGH: 1/11; BCL-2/IGH: 17/37). Equally important, patients who were not clonal in PB and/or BM by flow cytometry were identified as PCR+ (BCL-1/IGH: 3/11; BCL-2/IGH: 23/37). We conclude that this multiplex approach allows for easy and sensitive molecular determination of molecular lesions in NHL, which have diagnostic and prognostic importance.