Treatment Emergent Agranulocytosis with Skin and Gingival Lesions in a Chronic Lymphocytic Leukemia Patient: A Case Report
Published: October 1, 2016 | DOI: https://doi.org/10.7860/JCDR/2016/21334.8662
Ramesh Amirisetty, Varun Zade, Meenakshi Boddun, Rolly Gupta, Micky Kumari, Hema Suryawanshi
1. Professor, Department of Periodontology, Chhattisgarh Dental College and Research Institute, Rajnandgaon, Chhattisgarh, India.
2. Lecturer, Department of Periodontology, Chhattisgarh Dental College and Research Institute, Rajnandgaon, Chhattisgarh, India.
3. Lecturer, Department of Periodontology, Chhattisgarh Dental College and Research Institute, Rajnandgaon, Chhattisgarh, India.
4. Reader, Department of Oral Pathology and Microbiology, Chhattisgarh Dental College and Research Institute, Rajnandgaon, Chhattisgarh, India.
5. Postgraduate Student, Department of Periodontology, Chhattisgarh Dental College and Research Institute, Rajnandgaon, Chhattisgarh, India.
6. Professor and Head, Department of Oral Pathology and Microbiology, Chhattisgarh Dental College and Research Institute, Rajnandgaon, Chhattisgarh, India.
Correspondence Address :
Dr. Ramesh Amirisetty,
Chhattisgarh Dental College and Research Institute, Sundara, Rajnandgaon-491441, Chhattisgarh, India.
E-mail: rameshperio@icloud.com
Abstract
Chronic Lymphocytic Leukaemia (CLL) is a monoclonal lymphoid malignancy characterized by progressive accumulation of small, mature but functionally incompetent neoplastic lymphocytes in the peripheral blood, bone marrow and lymphoid organs. Patients present a variable course and may not require early intervention unlike other malignancies. Patients with rapidly deteriorating blood counts, and organomegaly need treatment. Alkylating agent live Bendamustine combined with Rituximab, anti-CD 20 monoclonal antibody have shown promising results in such patients. Anaemia, neutropenia and thrombocytopenia have been reported as treatment emergent events with this combination therapy. Neutrophils are the major innate defense and their depletion can result in a wide range of opportunistic infections. This case report discusess the oral and dermal lesions which emerged with the Rituximab and Bendamustine combination therapy in a patient with CLL and their management.
Keywords
Bendamustine, Gingival necrosis, Neutropenia, Rituximab