A Concise Review of Autoimmune Cytopenias in Chronic Lymphocytic Leukemia

Tsang, Mazie

doi:10.1007/s11899-017-0366-1

Cited by 41 publications

(44 citation statements)

References 73 publications

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“…Immune‐mediated hemolytic anemia is a recognized paraneoplastic syndrome in people . Chronic lymphocytic leukemia is a well‐established cause of IMHA in people . Other neoplasms have been associated with IMHA in humans, but the causal mechanisms remain elusive .…”

Section: Cancermentioning

confidence: 99%

ACVIM consensus statement on the diagnosis of immune‐mediated hemolytic anemia in dogs and cats

Garden

Kidd

Mexas

et al. 2019

Veterinary Internal Medicne

130

196

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Immune‐mediated hemolytic anemia (IMHA) is an important cause of morbidity and mortality in dogs. IMHA also occurs in cats, although less commonly. IMHA is considered secondary when it can be attributed to an underlying disease, and as primary (idiopathic) if no cause is found. Eliminating diseases that cause IMHA may attenuate or stop immune‐mediated erythrocyte destruction, and adverse consequences of long‐term immunosuppressive treatment can be avoided. Infections, cancer, drugs, vaccines, and inflammatory processes may be underlying causes of IMHA. Evidence for these comorbidities has not been systematically evaluated, rendering evidence‐based decisions difficult. We identified and extracted data from studies published in the veterinary literature and developed a novel tool for evaluation of evidence quality, using it to assess study design, diagnostic criteria for IMHA, comorbidities, and causality. Succinct evidence summary statements were written, along with screening recommendations. Statements were refined by conducting 3 iterations of Delphi review with panel and task force members. Commentary was solicited from several professional bodies to maximize clinical applicability before the recommendations were submitted. The resulting document is intended to provide clinical guidelines for diagnosis of, and underlying disease screening for, IMHA in dogs and cats. These should be implemented with consideration of animal, owner, and geographical factors.

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Section: Cancermentioning

confidence: 99%

ACVIM consensus statement on the diagnosis of immune‐mediated hemolytic anemia in dogs and cats

Garden

Kidd

Mexas

et al. 2019

Veterinary Internal Medicne

130

196

View full text Add to dashboard Cite

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“…Autoimmune cytopenias occur in ~5–10% CLL patients (most commonly autoimmune hemolytic anemia [AIHA] and immune thrombocytopenia) 83 . In the absence of significant CLL tumor burden, these should be treated with corticosteroids or single-agent rituximab.…”

Section: Special Situationsmentioning

confidence: 99%

Chronic lymphocytic leukemia treatment algorithm 2018

Parikh

2018

Blood Cancer Journal

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The treatment landscape for patients with chronic lymphocytic leukemia (CLL) has changed considerably with the introduction of very effective oral targeted therapies (such as ibrutinib, idelalisib, and venetoclax), and next-generation anti-CD20 monoclonal antibodies (such as obinutuzumab). These agents lead to improved outcomes in CLL, even among patients with high-risk features, such as del17p13 or TP53 mutation and unmutated immunoglobulin heavy chain (IGHV) genes. Each of these treatments is associated with a unique toxicity profile; in the absence of randomized data, the choice of one type of treatment over another depends on the co-morbidities of the patient. Chemoimmunotherapy still plays an important role in the management of previously untreated CLL patients, particularly among young fit patients who have standard risk FISH profile and mutated IGHV genes. Richter’s transformation of CLL remains a difficult complication to treat, although therapy with programmed death 1 inhibitors such as pembrolizumab and nivolumab has shown impressive responses in a subset of patients. Our ability to risk stratify CLL patients continues to evolve; the CLL-International Prognostic Index (CLL-IPI) is the best validated tool in predicting time to first therapy among previously untreated patients. This review summarizes the current approach to risk stratification and management of CLL patients.

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“…9 In fact, ibrutinib may play a therapeutic role in the prevention and treatment of AICs in patients with CLL. 10 This was illustrated in one retrospective study Figure 1.…”

Section: Discussionmentioning

confidence: 88%