Chronic Lymphocytic Leukemia-Associated Pure Red Cell Aplasia

D’Arena, Giovanni; Cascavilla, Nicola

doi:10.1177/039463200902200204

Cited by 11 publications

(9 citation statements)

References 46 publications

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“…Alemtuzumab has been reported to be active in steroid-refractory cases. 85 In the very refractory cases, allogeneic stem cell transplantation maybe necessary.…”

Section: Autoimmune Cytopeniasmentioning

confidence: 99%

Non-Hodgkin’s Lymphomas

Ad¹,

Js²,

Rh³

et al. 2010

J Natl Compr Canc Netw

223

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OverviewNon-Hodgkin's lymphomas (NHLs) are a heterogeneous group of lymphoproliferative disorders originating in B-, T-, or natural killer (NK) lymphocytes. In the United States, B-cell lymphomas represent 80% to 85% of all cases, with 15% to 20% being T-cell lymphomas; NK lymphomas are very rare. In 2009, an estimated 65,980 new cases of NHL will be diagnosed and 19,500 will die of the disease.1 NHL is the sixth leading site of new cancer cases among men and fifth among women, accounting for 4% to 5% of new cancer cases and 3% to 4% of cancer-related deaths. Non-Hodgkin's Lymphomas Clinical Practice Guidelines in OncologyKey Words NCCN Clinical Practice Guidelines, non-Hodgkin's lymphoma, chronic lymphocytic leukemia, follicular lymphoma, diffuse large B-cell lymphoma, mantle cell lymphoma, peripheral T-cell lymphoma, cutaneous T-cell lymphoma, mycosis fungoides, Sézary syndrome, marginal zone lymphoma, mucosaassociated lymphoid tissue lymphoma, diagnosis, treatment, hematopathology, immunohistochemistry, treatment guidelines, staging evaluation, lymphoma pathology (JNCCN 2010;8:288-334) NCCN Categories of Evidence and ConsensusCategory 1: The recommendation is based on high-level evidence (e.g., randomized controlled trials) and there is uniform NCCN consensus. Category 2A: The recommendation is based on lowerlevel evidence and there is uniform NCCN consensus. Category 2B: The recommendation is based on lowerlevel evidence and there is nonuniform NCCN consensus (but no major disagreement). Category 3: The recommendation is based on any level of evidence but reflects major disagreement. Please NoteThese guidelines are a statement of consensus of the authors regarding their views of currently accepted approaches to treatment. Any clinician seeking to apply or consult these guidelines is expected to use independent medical judgment in the context of individual clinical circumstances to determine any patient's care or treatment. The National Comprehensive Cancer Network makes no representation or warranties of any kind regarding their content, use, or application and disclaims any responsibility for their applications or use in any way.These guidelines are copyrighted by the National Comprehensive Cancer Network. All rights reserved. These guidelines and the illustrations herein may not be reproduced in any form without the express written permission of the NCCN © 2010. Disclosures for the NCCN Non-Hodgkin's Lymphomas Guidelines PanelAt the beginning of each NCCN guidelines panel meeting, panel members disclosed any financial support they have received from industry. Through 2008, this information was published in an aggregate statement in JNCCN and online. Furthering NCCN's commitment to public transparency, this disclosure process has now been expanded by listing all potential conflicts of interest respective to each individual expert panel member.Individual disclosures for the NCCN Non-Hodgkin's Lymphomas Guidelines Panel members can be found on page 334. (To view the most recent version of these guideli...

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“…Alemtuzumab has been reported to be active in steroid-refractory cases. 85 In the very refractory cases, allogeneic stem cell transplantation maybe necessary.…”

Section: Autoimmune Cytopeniasmentioning

confidence: 99%

Non-Hodgkin’s Lymphomas

Ad¹,

Js²,

Rh³

et al. 2010

J Natl Compr Canc Netw

223

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“…MBL, an increasingly recognized entity with an approximate incidence of 5% in individuals older than 60 years with normal lymphocyte counts, has a 1.1% yearly progression rate to CLL and does not usually warrant extensive evaluation . However, as illustrated here, autoimmune hematologic phenomena can precede the development of CLL and are recognized to be more frequent when the malignant clone's heavy‐chain variable region sequence is unmutated . To our knowledge, this is the first report of MBL presenting with AVWS.…”

Section: Discussionmentioning

confidence: 82%

Maintaining hemostasis in acquired von Willebrand syndrome: a review of intravenous immunoglobulin and the importance of rituximab dose scheduling

Kanakry

Gladstone

2012

Transfusion

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“…However, an alternative notion supporting the main role of T and NK-cells in suppression of erythropoiesis has also been proposed (reviewed by D'Arena and Cascavilla [6]). In fact, experimental studies showed that the inhibition of erythropoiesis is due to the dysfunction of the so-called γδ T cells carrying the Fc receptor for IgG (CD16) [57–64].…”

Section: Pathogenesismentioning

confidence: 99%

“…The combination of FAMP, cyclophosphamide and anti-CD20 monoclonal antibody rituximab (FCR regimen) has emerged as the current standard of care in the treatment of younger CLL patients [66]. AIHA may complicate FAMP therapy [6]. Table 4 summarizes data on the incidence of AIHA in FAMP-treated CLL patients from some of the largest studies published so far.…”

Section: Fludarabine-related Autoimmune Aihamentioning

confidence: 99%

“…D'Arena et al reviewed data on the use of such antibodies to treat CLL-associated AIHA and reported a personal experience on the successful use of rituximab in small series of ITP and PRCA patients with CLL [4, 6, 77, 78]. Positive results with alemtuzumab for AIHA in CLL patients have been reported by Karlsson et al in five patients resistant to other conventional treatments [79].…”

Section: Treatment Of Cll-associated Acmentioning

confidence: 99%

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Autoimmune Cytopenias in Chronic Lymphocytic Leukemia

D’Arena

Guariglia

Rocca

et al. 2013

Clinical and Developmental Immunology

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The clinical course of chronic lymphocytic leukemia (CLL) may be complicated at any time by autoimmune phenomena.The most common ones are hematologic disorders, such as autoimmune hemolytic anemia (AIHA) and immune thrombocytopenia (ITP). Pure red cell aplasia (PRCA) and autoimmune agranulocytosis (AG) are, indeed, more rarely seen. However, they are probably underestimated due to the possible misleading presence of cytopenias secondary to leukemic bone marrow involvement or to chemotherapy cytotoxicity. The source of autoantibodies is still uncertain, despite the most convincing data are in favor of the involvement of resting normal B-cells. In general, excluding the specific treatment of underlying CLL, the managementof these complications is not different from that of idiopathic autoimmune cytopenias or of those associated to other causes. Among different therapeutic approaches, monoclonal antibody rituximab, given alone or in combination, has shown to be very effective.

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Chronic Lymphocytic Leukemia-Associated Pure Red Cell Aplasia

Cited by 11 publications

References 46 publications

Non-Hodgkin’s Lymphomas

Non-Hodgkin’s Lymphomas

Maintaining hemostasis in acquired von Willebrand syndrome: a review of intravenous immunoglobulin and the importance of rituximab dose scheduling

Autoimmune Cytopenias in Chronic Lymphocytic Leukemia

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