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Objective To explore the curative effect of ibrutinib in treatment of autoimmune cytopenia (AIC) after hematopoietic stem cell transplantation (HSCT). Methods Two leukemia patients receiving HSCT at our hospital in 2016 and 2018 respectively were enrolled in this study, who were subsequently diagnosed as Evans syndrome (case 2) and pure red cell aplastic Anemia (PRCA) (case 1) respectively after transplantation. Due to failing to the treatment of glucocorticoid, immunoglobulin, immunosuppressants, plasma exchange and blood transfusion support, ibrutinib was tentatively applied to the patients, and its therapeutic effects and the changes of immune indexes were observed. Results After ibrutinib treatment, case 1 needed fewer times of red blood cell transfusion than before, with decreased level of anti-donor blood group antibodies and gradually elevated hemoglobin level. She was gradually relieved of blood transfusion, and then achieved complete remission about 3 months after the treatment. As for case 2, she was released from platelet infusion approximately 2 weeks after the ibrutinib treatment, with progressively improved hemoglobin level and platelet count, got weakly positive result to direct antiglobulin test (DAT) and negative result to autoantibodies, and achieved complete remission as well. No obvious adverse drug reactions or recurrence of primary disease were observed in the 2 patients. Conclusion Ibrutinib has certain efficacy in the treatment for PRCA or Evans syndrome after HSCT.

Objective: To improve the understanding of splenectomy for treating common variable immunodeficiency complicated with cytopenia. Methods: A case of common variable immunodeficiency complicated with cytopenia was reported, and the literature was reviewed. Results: The patient, female, 16 years old, was hospitalized for eight years due to thrombocytopenia; she manifested recurrent thrombocytopenia with leukopenia since adolescence. The patient was diagnosed with common variable immunodeficiency with repeated mild infections, splenomegaly, and significantly reduced plasma immunoglobulin levels. Additionally, splenectomy was performed with adequate immunoglobulin replacement therapy, and the pathology confirmed hypersplenism; her blood cell level returned to normal after surgery. Conclusions: Common variable immunodeficiency has various clinical manifestations and can be complicated with cytopenia. Under the premise of adequate immunoglobulin replacement therapy, splenectomy is a safe and effective treatment for common variable immunodeficiency in patients with recurrent cytopenia.