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. Serment-d'hippocrate,

, Au moment d'être admis à exercer la médecine, je promets et je jure d'être fidèle aux lois de l'honneur et de la probité

, Mon premier souci sera de rétablir, de préserver ou de promouvoir la santé dans tous ses éléments, physiques et mentaux

, Je respecterais toutes les personnes, leur autonomie et leur volonté, sans aucune discrimination selon leur état ou leurs convictions. J'interviendrai pour les protéger si elles sont affaiblies, vulnérables ou menacées dans leur intégrité ou leur dignité. Même sous la contrainte je ne ferai pas usage de mes connaissances

, J'informerai les patients des décisions envisagées, de leurs raisons et de leurs

, Je ne tromperai jamais leur confiance et n'exploiterai pas le pouvoir hérité des circonstances pour forcer les consciences

, Je donnerai mes soins à l'indigent et à quiconque me les demandera. Je ne me laisserai pas influencer par la soif du gain ou la recherche de la gloire

, Admis dans l'intimité des personnes, je tairai les secrets qui me seront confiés. Reçu à l'intérieur des maisons, je respecterai les secrets des foyers et ma conduite ne servira pas à corrompre les moeurs

, Je ferai tout pour soulager les souffrances. Je ne prolongerai pas abusivement les agonies. Je ne provoquerai jamais la mort délibérément

, Je n'entreprendrais rien qui dépasse mes connaissances. Je les entretiendrai et les perfectionnerai pour assurer au mieux les services qui me seront demandés

, J'apporterai mon aide à mes confrères ainsi qu'à leurs familles dans l'adversité

, Que les hommes et mes confrères m'accordent leur estime si je suis fidèle à mes

, chronique (LLC) est complexe et peu codifiée, en particulier lorsque celles-ci sont réfractaires aux traitements de première ligne, reposant alors sur le traitement de la LLC ellemême. L'Ibrutinib, chef de file des inhibiteurs de la tyrosine kinase de Bruton, n'a jamais été évalué dans cette indication bien que quelques cas cliniques en rapportent l'efficacité

. Materiel and . Methode, Notre étude rétrospective portait sur une cohorte de 11 patients atteints de LLC compliquée de CAI réfractaires dont 7 anémies hémolytiques auto-immunes (AHAI), 3 purpuras thrombopéniques immunologiques

R. Bordeaux and . Et-toulouse, L'objectif principal était d'évaluer la réponse au traitement par Ibrutinib sur les CAI, les objectifs secondaires étaient d'étudier la tolérance et les effets indésirables du traitement

E. Dans-notre, Ibrutinib apparait comme une option thérapeutique intéressante dans la prise en charge des CAI associées à la LLC. Son évaluation spécifique semblerait intéressante pour les patients présentant une CAI associée à une LLC non active, c'est-à-dire sans indication de traitement spécifique par immuno-chimiothérapie

, Mots-clés : Ibrutinib ; AHAI ; PTI ; LLC