American Journal of Hematology 69:232±235 (2002) LETTERS AND CORRESPONDENCE Letters and correspondence submitted for possible publication must be identi®ed as such Text length must not exceed 500 words and ®ve bibliographic references A single concise ®gure or table may be included if it is essential to support the communication Letters not typed double-spaced will not be considered for publication Letters not meeting these speci®cations will not be returned to authors Letters to the Editor are utilized to communicate a single novel observation or ®nding Correspondence is to be used to supplement or constructively comment on the contents of a publication in the journal and cannot exceed the restrictions for Letters to the Editor The Editor reserves the right to shorten text, delete objectional comments, and make other changes to comply with the style of the journal Permission for publication must be appended as a postscript Submissions must be sent to Paul Chervenick, M.D., Editor of Brief Reports/Letters to Editors, American Journal of Hematology, H Lee Mof®tt Cancer Center, University of South Florida, 12902 Magnolia Drive, Tampa, FL 33612 to permit rapid consideration for publication Successful Treatment of Steroid and Cyclophosphamide-Resistant Hemolysis in Chronic Lymphocytic Leukemia With Rituximab To the Editor: Chronic lymphocytic leukemia was diagnosed in a 63year-old female patient in May 1991 Peripheral blood smears showed increased leucocytes (18,500/ll) with up to 90% lymphocytes positive for CD 19 (97%) and CD (52%) Bone marrow involvement was 80% Initial CT scans showed multiple lymphomas at different regions enlarged up to cm Thrombocytes were slightly decreased to 127,000/ll and hemoglobin was normal with 14.3 g/dl Treatment with chlorambucil (6 mg/m2 p.o.; days 1À3) and prednisone (75 mg/day p.o day 1, 50 mg/day p.o day 2, 25 mg/day p.o day 3) repeated every weeks was initiated between December 1993 and September 1994 and between June 1996 and April 1997 In October 1998 the patient developed progressive disease with 88% lymphocytes in the peripheral blood smears, 90% bone marrow in®ltration, multiple abdominal lymphomas enlarged up to cm, progressive splenomegaly and, in addition autoimmune hemolytic anemia (AIHA) Repeated treatment with chlorambucil and prednisone yielded no response In February 1999 irradiation of the spleen (8 Gy) was initiated because of massive splenic enlargement (30 cm) During radiation therapy a dramatic aggravation of hemolysis developed Laboratory data were: leucocytes 6,500/ll, platelets 57,000/ll, hemoglobin 5.7 g/dl, bilirubin 6.0 mg/dl, indirect bilirubin 4.9 mg/dl, haptoglobin