Preexisting and treatment-emergent autoimmune cytopenias in patients with CLL treated with targeted drugs
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Le résumé fourni par la source
Autoimmune cytopenias (AICs) affect 5% to 9% of patients with chronic lymphocytic leukemia (CLL). Targeted drugs-ibrutinib, idelalisib, and venetoclax-have a prominent role in the treatment of CLL, but their impact on CLL-associated AICs is largely unknown. In this study, we evaluated the characteristics and outcome of preexisting AICs and described the incidence, quality, and management of treatment-emergent AICs during therapy with targeted drugs in patients with CLL. We collected data from 572 patients treated with ibrutinib (9% in combination with an anti-CD20 monoclonal antibody), 143 treated with idelalisib-rituximab, and 100 treated with venetoclax (12% in combination with an anti-CD20 monoclonal antibody). A history of preexisting AICs was reported in 104 (13%) of 815 patients. Interestingly, 80% of patients whose AICs had not resolved when treatment with a targeted drug was started experienced an improvement or a resolution during therapy. Treatment-emergent AICs occurred in 1% of patients during ibrutinib therapy, in 0.9% during idelalisib therapy, and in 7% during venetoclax therapy, with an estimated incidence rate of 5, 6, and 69 episodes per 1000 patients per year of exposure in the 3 treatment groups, respectively. The vast majority of patients who developed treatment-emergent AICs had unfavorable biological features such as an unmutated IGHV and a del(17p) and/or TP53 mutation. Notably, despite AICs, 83% of patients were able to continue the targeted drug, in some cases in combination with additional immunosuppressive agents. Overall, treatment with ibrutinib, idelalisib, or venetoclax seems to have a beneficial impact on CLL-associated AICs, inducing an improvement or even a resolution of preexisting AICs in most cases and eliciting treatment-emergent AICs in a negligible portion of patients.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Preexisting and treatment-emergent autoimmune cytopenias in patients with CLL treated with targeted drugs
- Date Crossref
- 24/06/2021
- Éditeur
- American Society of Hematology
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Azienda Ospedaliera Citta' della Salute e della Scienza di Torino pays non établi dans la noticeÉtablissement de santé
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Policlinico Umberto I pays non établi dans la noticeÉtablissement de santé
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IRCCS Ospedale San Raffaele pays non établi dans la noticeÉtablissement de santé
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Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda pays non établi dans la noticeÉtablissement de santé
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University of Padua pays non établi dans la noticeUniversité ou école supérieure
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Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Hematology Unit pays non établi dans la noticeÉtablissement de santé
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Ospedale Maggiore pays non établi dans la noticeÉtablissement de santé
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Agostino Gemelli University Polyclinic pays non établi dans la noticeÉtablissement de santé
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Azienda Ospedaliera Citta' della Salute e della Scienza di Torino, Policlinico Umberto I et IRCCS Ospedale San Raffaele, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.