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In the present study, we demonstrate that relapsed refractory patients with chronic lymphocytic leukaemia treated with idelalisib rituximab on the phase III registration trial show uniform decrease in regulatory T cells (Tregs) and increase in CD8 T cells with treatment. Patients who do not develop toxicity show enrichment for T cells expressing multiple chemokine receptors, while those who do develop toxicity have an activated CD8 T cell population with T helper 17 cell differentiation at baseline, which then increases, leading to an increased CD8:Treg ratio that likely triggers autoimmune toxicity.<\/jats:p>","DOI":"10.1111\/bjh.18053","type":"journal-article","created":{"date-parts":[[2022,2,16]],"date-time":"2022-02-16T01:43:26Z","timestamp":1644975806000},"page":"207-211","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Idelalisib reduces regulatory T cells and activates T helper 17 cell differentiation in relapsed refractory patients with chronic lymphocytic leukaemia"],"prefix":"10.1111","volume":"197","author":[{"given":"Deepti","family":"Gadi","sequence":"first","affiliation":[{"name":"Department of Medical Oncology Dana\u2010Farber Cancer Institute  Boston MA USA"},{"name":"Department of Medicine Harvard Medical School  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alec","family":"Griffith","sequence":"additional","affiliation":[{"name":"Department of Surgery Brigham and Women's Hospital  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zixu","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Data Sciences Dana\u2010Farber Cancer Institute  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Svitlana","family":"Tyekucheva","sequence":"additional","affiliation":[{"name":"Department of Data Sciences Dana\u2010Farber Cancer Institute  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa","family":"Rai","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Dana\u2010Farber Cancer Institute  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stacey M.","family":"Fernandes","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Dana\u2010Farber Cancer Institute  Boston MA USA"},{"name":"Department of Medicine Harvard Medical School  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John\u2010Hanson","family":"Machado","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Dana\u2010Farber Cancer Institute  Boston MA USA"},{"name":"Department of Medicine Harvard Medical School  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2390-3822","authenticated-orcid":false,"given":"Veerendra","family":"Munugalavadla","sequence":"additional","affiliation":[{"name":"Gilead Sciences, Inc.  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