Worsening of immune thrombocytopenia following Covid-19 vaccination

[Jm954]

Immune thrombocytopenia can be a recognised complication of CLL due to our dysregulated immune system. This abstract reports that COVID-19 vaccination may adversely affect immune thrombocytopenia (ITP) patients although it does not specifically mention CLL ITP patients.

52 consecutive chronic ITP patients were prospectively followed after COVID-19 vaccination. 15% had no worsening of clinical symptoms but no post-vaccination platelet count; 73% had no new symptoms and no platelet count decline. However, 12% had a median platelet count drop of 96% within 2-5 days post-vaccination with new bleeding symptoms; after rescue therapy with corticosteroids +/-IVIG, platelets recovered to >30x109 /L a median 3 days later.

ITP exacerbation occurred independent of ITP remission status, concurrent ITP treatment, vaccine type. Safety of a second vaccine dose needs careful assessment.

Reference here: pubmed.ncbi.nlm.nih.gov/340...

If you have ITP with your CLL please discuss monitoring your platelet count with your doctor in the days following your vaccination.

Jackie

[Ghounds]

Thank you for this Jackie.

[Accordion]

Thank you for posting this. I have CLL since 10 years and troublesome ITP complication since six years. My specialist hematologist has advised me to wait with vaccination until more research is made regarding risks and antibody production. So I am unvaccinated. But considering the likelihood of me getting any antibodies, I must protect myself anyway, everywhere. Outdoors I feel quite free to meet anyone on short distance.Best wishes to you all

Christina

[Walkingtall62]

My word, you have been a busy bee!!! Thanks for all!!

[charliegirl]

Thanks for posting this. I developed ITP for first time after first Pfizer vaccination although it wasn't picked up until I had a routine blood test 8 weeks later. It resolved with a short burst of dexamethasone. I was advised to have second vaccination and now 4 weeks later my platelets have again dropped.I also have AIHA and so my immune system seems prone to misbehaving.

I've reported this to the MHRA via the yellow card system and they are taking an interest

Charlie Girl

[Jm954 Administrator in reply to charliegirl]

Thanks for reporting it.

[bbreeland in reply to charliegirl]

I'm in the same situation- have your platelets rebounded now? Did you have fatigue?

[charliegirl in reply to bbreeland]

HiYou're the first person with CLL and ITP after Covid vaccination that I've heard about although I've now seen at least one paper confirming that a number of non CLL patients with pre existing ITP who had exacerbations post vaccine.

Yes I certainly had fatigue accompanying the ITP and my consultant told me this was not unexpected with ITP. My platelets recovered to near normal levels (120) but are now just below 70. I await next test in 2 weeks time to see if it will be as bad as before.

How soon after vaccination did your platelets drop and have you had steroids? I felt better by about a week after finishing the steroids.

If you're in UK do report to MHRA / Yellow Card notification if you haven't already done this. They have a special section for Civid vaccine reactions and you can self report.

I shall be very interested in how you get on and hope you feel better very soon

Best wishes

Charlie Girl

[Shepherd777]

My wife had the live covid-19 disease and was very sick with headaches, body aches, lost of taste, breathing problems, nausea, etc. so we have been reluctant to get the vaccine. Some of our doctors have concurred with the waiting a while and your post has reinforced the wait for us for the time being. Years ago we had some live vaccines and never got those diseases so we are praying the live covid will be as good as previous live vaccines.