Venetoclax for treating refractory autoimmune hemolytic anemia in chronic lymphocytic leukemia: report of two cases in Spain

Abstract

Not available.

The Role of the Spleen and the Place of Splenectomy in Autoimmune Hemolytic Anemia—A Review of Current Knowledge

“…For example, rozanolixumab, the inhibitor of neonatal Fc receptor (FcRn), shortens IgG half-life from a normal 28 days to about 10% and is currently approved for the treatment of myasthenia gravis; fostamatinib [ 62 ], the splenic tyrosine kinase inhibitor, inhibits cellular mediators of phagocytosis and reduces the clearance of RBCs and platelets and is currently approved for the treatment of ITP; bruton tyrosine kinase inhibitors ibrutinib [ 63 , 64 , 65 , 66 , 67 , 68 ] and acalabrutinib are currently approved for treatment of CLL, and rizabrutinib is approved for the treatment of ITP; and sirolimus [ 69 ], the inhibitor of the mechanistic target of rapamycin kinase (mTOR), is approved for the treatment of malignant perivascular epithelioid cell tumors and is also effective in the prevention of graft rejection following organ transplant [ 14 , 55 , 62 , 69 , 70 , 71 , 72 ]. Idelalisib, which is a PI3K inhibitor, and venetoclax, a selective inhibitor of the anti-apoptotic protein B-cell lymphoma 2 (Bcl-2), are emerging as promising agents for the treatment of AIHA associated with CLL [ 63 , 73 ].…”

“…Alemtuzumab, an mAb targeting CD52, may be useful in secondary wAIHA in the context of lymphoproliferative disorders [ 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 ]. The results of reports of targeted therapy in patients with primary and secondary wAIHA with sufficient clinical data are summarized in Table 2 [ 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 73 , 75 , 76 , 77 , 78 , 79 , 80 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 ]. Molecules that target the complement cascade, such as the C3 inhibitor pegcetacoplan and the C1q inhibitor cinryze, are reported to be effective in severe complement-mediated AIHA [ 93 , 94 ].…”

“…Molecules that target the complement cascade, such as the C3 inhibitor pegcetacoplan and the C1q inhibitor cinryze, are reported to be effective in severe complement-mediated AIHA [93,94]. 2023 [73] Abbreviations: wAIHA-warm autoimmune hemolytic anemia; FcRn-neonatal Fc receptor; mAb-monoclonal antibody; syk-splenic tyrosine kinase; BTK-bruton tyrosine kinase; PI3Kδ -phosphatidylinositol 3-kinase δ inhibitor; mTOR-mammalian target of rapamycin; Bcl-2-B-cell lymphoma 2; CLL-chronic lymphocytic leukemia; MCL-mantle cell lymphoma; PR-partial response; i.v.-intravenous: s.c.-subcutaneous; p.o.-orally (per os); qd-once daily; bid-twice daily; qw-once weekly; biw-twice weekly; tiw-three times weekly; NA-not applicable * patients with uncontrolled AIHA requiring >20 mg prednisone daily were excluded from the RESONATE study.…”

Diagnostic and therapeutic recommendations of the Polish Society of Haematologists and Transfusiologists, and Polish Adult Leukemia Group-CLL for chronic lymphocytic leukemia in 2023

“…Treatment with ibrutinib or idelalisib may have a beneficial effect on the course of autoimmune cytopenia [107,108,117]. Individual reports also suggest that venetoclax may have a similar effect [118,119], although cases of AIHA induction in CLL patients treated with venetoclax have also been described [120,121].…”