{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T10:30:33Z","timestamp":1785148233186,"version":"3.55.0"},"reference-count":9,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T00:00:00Z","timestamp":1779062400000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Chronic lymphocytic leukemia (CLL) can be complicated by autoimmune cytopenias, including autoimmune hemolytic anemia and immune thrombocytopenia (ITP), as observed in Evans syndrome. We report the case of a 75\u2010year\u2010old man with CLL who developed steroid\u2010 and rituximab\u2010refractory Evans syndrome during the ramp\u2010up phase of venetoclax treatment. The patient presented worsening of preexisting subclinical hemolysis that had been present before starting venetoclax, along with severe ITP (platelets 0\u2009\u00d7\u200910\n                    <jats:sup>9<\/jats:sup>\n                    \/L), unresponsive to standard therapies including steroids, immunoglobulins, and rituximab. Rescue treatment with the combination of romiplostim, a thrombopoietin receptor agonist, and zanubrutinib, a second\u2010generation Bruton's tyrosine kinase inhibitor, led to complete and sustained platelet recovery within 4\u2009weeks. This case highlights the potential of combining zanubrutinib with a thrombopoietin receptor agonist in managing severe ITP secondary to CLL, particularly when conventional therapies fail.\n                  <\/jats:p>","DOI":"10.1002\/ccr3.72697","type":"journal-article","created":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T03:54:38Z","timestamp":1779162878000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Successful Treatment of Evans Syndrome Onset With Zanubrutinib in Combination With Romiplostim During Venetoclax Treatment in a Patient With Chronic Lymphocytic Leukemia: A Case Report"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7596-1912","authenticated-orcid":false,"given":"Vanessa","family":"Innao","sequence":"first","affiliation":[{"name":"U.O.C di Ematologia Azienda Ospedaliera di Rilievo Nazionale e di Alta Specializzazione, ARNAS Garibaldi di Catania  Catania Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessia Paola Maria","family":"Barbagallo","sequence":"additional","affiliation":[{"name":"U.O.C di Ematologia Azienda Ospedaliera di Rilievo Nazionale e di Alta Specializzazione, ARNAS Garibaldi di Catania  Catania Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oriana","family":"Bianco","sequence":"additional","affiliation":[{"name":"U.O.C di Ematologia Azienda Ospedaliera di Rilievo Nazionale e di Alta Specializzazione, ARNAS Garibaldi di Catania  Catania Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerio","family":"Leotta","sequence":"additional","affiliation":[{"name":"U.O.C di Ematologia Azienda Ospedaliera di Rilievo Nazionale e di Alta Specializzazione, ARNAS Garibaldi di Catania  Catania Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ugo","family":"Consoli","sequence":"additional","affiliation":[{"name":"U.O.C di Ematologia Azienda Ospedaliera di Rilievo Nazionale e di Alta Specializzazione, ARNAS Garibaldi di Catania  Catania Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,18]]},"reference":[{"issue":"3","key":"e_1_2_13_2_1","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1002\/ajh.27546","article-title":"Chronic Lymphocytic Leukemia: 2025 Update on Epidemiology, Pathogenesis, Diagnosis, and Therapy","volume":"100","author":"Hallek M.","year":"2025","journal-title":"American Journal of Hematology"},{"issue":"2","key":"e_1_2_13_3_1","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1016\/j.hoc.2021.12.004","article-title":"Adult Evans' Syndrome","volume":"36","author":"Michel M.","year":"2022","journal-title":"Hematology\/Oncology Clinics of North America"},{"issue":"8","key":"e_1_2_13_4_1","doi-asserted-by":"crossref","first-page":"e617","DOI":"10.1016\/S2352-3026(24)00144-3","article-title":"Diagnosis and Management of Evans Syndrome in Adults: First Consensus Recommendations","volume":"11","author":"Fattizzo B.","year":"2024","journal-title":"Lancet Haematology"},{"issue":"26","key":"e_1_2_13_5_1","doi-asserted-by":"crossref","first-page":"2706","DOI":"10.1182\/blood.2024024667","article-title":"Sustained Benefit of Zanubrutinib vs Ibrutinib in Patients With R\/R CLL\/SLL: Final Comparative Analysis of ALPINE","volume":"144","author":"Brown J. R.","year":"2024","journal-title":"Blood"},{"key":"e_1_2_13_6_1","doi-asserted-by":"crossref","DOI":"10.1038\/srep39003","article-title":"Efficacy and Safety of Thrombopoietin Receptor Agonists in Patients With Primary Immune Thrombocytopenia: A Systematic Review and Meta\u2010Analysis","volume":"6","author":"Wang L.","year":"2016","journal-title":"Scientific Reports"},{"key":"e_1_2_13_7_1","doi-asserted-by":"crossref","DOI":"10.1177\/20406207231205431","article-title":"Rilzabrutinib Versus Placebo in Adults and Adolescents With Persistent or Chronic Immune Thrombocytopenia: LUNA 3 Phase III Study","volume":"14","author":"Kuter D. J.","year":"2023","journal-title":"Therapeutic Advances in Hematology"},{"key":"e_1_2_13_8_1","unstructured":"D. J.Kuter \u201cEfficacy and Safety of Oral Bruton Tyrosine Kinase Inhibitor (BTKi) Rilzabrutinib in Adults With Previously Treated Immune Thrombocytopenia (ITP): A Phase 3 Placebo\u2010Controlled Parallel\u2010Group Multicenter Study (LUNA 3) \u201d2024 ASH Annual Meeting Abs 5."},{"issue":"6","key":"e_1_2_13_9_1","doi-asserted-by":"crossref","first-page":"e254","DOI":"10.3324\/haematol.2015.138289","article-title":"Autoimmune Cytopenias in Patients With Chronic Lymphocytic Leukemia Treated With Ibrutinib","volume":"101","author":"Vitale C.","year":"2016","journal-title":"Haematologica"},{"issue":"6","key":"e_1_2_13_10_1","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1080\/17474086.2024.2356257","article-title":"Evaluating Zanubrutinib for the Treatment of Adults With Chronic Lymphocytic Leukemia or Small Lymphocytic Lymphoma","volume":"17","author":"Javidi\u2010Sharifi N.","year":"2024","journal-title":"Expert Review of Hematology"}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.72697","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccr3.72697","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.72697","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T03:54:45Z","timestamp":1779162885000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.72697"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":9,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1002\/ccr3.72697"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.72697","archive":["Portico"],"relation":{},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"value":"2050-0904","type":"print"},{"value":"2050-0904","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5]]},"assertion":[{"value":"2026-01-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-28","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e72697"}}