Treatment of refractory autoimmune hemolytic anemia with venetoclax in relapsed chronic lymphocytic leukemia with del(17p)

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“…Activity in secondary wAIHA has been described, even this is not confirmed in other reports [230,231].…”

Section: Predictors Of Relapsementioning

confidence: 68%

Diagnosis and treatment of autoimmune hemolytic anemia in adults: Recommendations from the First International Consensus Meeting

et al. 2020

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“…Data on venetoclax effects on CLL related AIC are so far anecdotal. A CLL patient with del(17p) and refractory AIHA was successfully treated with venetoclax obtaining a response after three months of therapy [77]. Consistently, venetoclax administration was reported to induce an early occurring (i.e., during the rump-up phase) and persistent response in two patients with CLL and concomitant AIC (one ITP and one Evans syndrome) [78].…”

Section: Targeted Agents For the Treatment Of Autoimmune Complicationmentioning

confidence: 80%

Autoimmune Complications in Chronic Lymphocytic Leukemia in the Era of Targeted Drugs

Vitale

Montalbano

Salvetti

et al. 2020

Cancers

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Autoimmune phenomena are frequently observed in patients with chronic lymphocytic leukemia (CLL) and are mainly attributable to underlying dysfunctions of the immune system. Autoimmune cytopenias (AIC) affect 4–7% of patients with CLL and mainly consist of autoimmune hemolytic anemia and immune thrombocytopenia. Although less common, non-hematological autoimmune manifestations have also been reported. Treatment of CLL associated AIC should be primarily directed against the autoimmune phenomenon, and CLL specific therapy should be reserved to refractory cases or patients with additional signs of disease progression. New targeted drugs (ibrutinib, idelalisib and venetoclax) recently entered the therapeutic armamentarium of CLL, showing excellent results in terms of efficacy and became an alternative option to standard chemo-immunotherapy for the management of CLL associated AIC. However, the possible role of these drugs in inducing or exacerbating autoimmune phenomena still needs to be elucidated. In this article, we review currently available data concerning autoimmune phenomena in patients with CLL, particularly focusing on patients treated with ibrutinib, idelalisib, or venetoclax, and we discuss the possible role of these agents in the management of AIC.

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“…9,39 The Bcl-2 inhibitor venetoclax seems to be effective against AIHA as well, although few cases have been published so far. 40,41 Novel anti-CD20 antibodies such as ofatumumab or obinutuzumab should have at least similar activity as rituximab, but published data are rare. 42 CLL guidelines now recommend use of BTK or Bcl2 inhibitors in most cases.…”

Section: Treatment Of Aiha And/or Lymphoma With Chemoimmunotherapy or Novel Agentsmentioning

confidence: 99%

“…89 As discussed, ibrutinib and venetoclax seem to be beneficial in part by targeting both, the lymphoma as well as the AIC. [34][35][36][37][38][39][40][41]92 Conclusions and future developments Autiommune conditions can occur at any time before, during or after lymphoma diagnosis and treatment. AICs may be the indication for treatment either by immunosuppression or antineoplastic agents.…”

Section: Course Of Autoimmune Condition During and After Antilymphoma Treatmentmentioning

confidence: 99%

How I manage autoimmune cytopenias in patients with lymphoid cancer

Porpaczy¹,

Jaeger

2022

Blood

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Autoimmune conditions can occur at any temporary relationship with malignant lymphomas. In many instances, treatment at diagnosis is not required, but symptomatic autoimmune conditions represent an indication for treatment particularly in chronic lymphoproliferative diseases. Treatment is selected depending on the predominant condition - autoimmune disease (immunosuppression) or lymphoma (anti-lymphoma therapy). Steroids as well as anti-CD20 antibodies are effective against both and may suppress the autoimmune complication for a prolonged period. Efficacy of B-cell receptor inhibitors has provided us with novel insights into the pathophysiology of antibody-producing B-cells. Screening for underlying autoimmune conditions is part of the lymphoma work-up since other drugs like immunomodulators or checkpoint inhibitors should be avoided or used with caution. Here we discuss diagnostic challenges and treatment approaches for different situations involving lymphomas and autoimmune cytopenias.

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Treatment of refractory autoimmune hemolytic anemia with venetoclax in relapsed chronic lymphocytic leukemia with del(17p)

Cited by 22 publications

References 5 publications

Diagnosis and treatment of autoimmune hemolytic anemia in adults: Recommendations from the First International Consensus Meeting

Diagnosis and treatment of autoimmune hemolytic anemia in adults: Recommendations from the First International Consensus Meeting

Autoimmune Complications in Chronic Lymphocytic Leukemia in the Era of Targeted Drugs

How I manage autoimmune cytopenias in patients with lymphoid cancer

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