Five cases of chronic lymphocytic leukemia complicated by thrombocytopenic purpura are presented. They differed from the usual cases with this complication in that megakaryocytes were plentiful in spite of leukemic involvement of the bone marrow. Hypersplenism did not appear to be a factor.

The evidence suggests that the thrombocytopenia was of an autoimmune nature, due to antiplatelet antibodies. Brief platelet survival times, the presence of a platelet agglutinin, staining of megakaryocytes by fluorescein-labeled anti-human globulin, and responses to corticosteroids were demonstrated.

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