{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T09:28:08Z","timestamp":1787563688016,"version":"build-2736575974"},"reference-count":39,"publisher":"American Society of Hematology","issue":"25","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,6,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Autoimmune cytopenias (AICs) affect 5% to 9% of patients with chronic lymphocytic leukemia (CLL). Targeted drugs\u2014ibrutinib, idelalisib, and venetoclax\u2014have 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.<\/jats:p>","DOI":"10.1182\/blood.2020008201","type":"journal-article","created":{"date-parts":[[2021,3,2]],"date-time":"2021-03-02T16:53:12Z","timestamp":1614703992000},"page":"3507-3517","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":44,"title":["Preexisting and treatment-emergent autoimmune cytopenias in patients with CLL treated with targeted drugs"],"prefix":"10.1182","volume":"137","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2592-8724","authenticated-orcid":false,"given":"Candida","family":"Vitale","sequence":"first","affiliation":[{"name":"Department of Molecular Biotechnology and Health Sciences, University of Torino\u2013Division of Hematology, Azienda Ospedaliero-Universitaria (AOU) Citt\u00e0 della Salute e della Scienza di Torino, Turin, Italy;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Salvetti","sequence":"additional","affiliation":[{"name":"Department of Molecular Biotechnology and Health Sciences, University of Torino\u2013Division of Hematology, Azienda Ospedaliero-Universitaria (AOU) Citt\u00e0 della Salute e della Scienza di Torino, Turin, Italy;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1589-1195","authenticated-orcid":false,"given":"Valentina","family":"Griggio","sequence":"additional","affiliation":[{"name":"Department of Molecular Biotechnology and Health Sciences, University of Torino\u2013Division of Hematology, Azienda Ospedaliero-Universitaria (AOU) Citt\u00e0 della Salute e della Scienza di Torino, Turin, Italy;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marika","family":"Porrazzo","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Translational and Precision Medicine, Sapienza University, Policlinico Umberto I, Rome, Italy;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luana","family":"Schiattone","sequence":"additional","affiliation":[{"name":"Strategic Research Program on Chronic Lymphocytic Leukemia (CLL), B-Cell Neoplasia Unit, Division of Experimental Oncology, IRCCS Ospedale San Raffaele, Milan, Italy;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Zamprogna","sequence":"additional","affiliation":[{"name":"Department of Hematology, Niguarda Cancer Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, 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