C039 | Impact of Venetoclax-based Therapies on Autoimmune Cytopenias in Patients With Chronic Lymphocytic Leukemia: Final Analysis of a Multicenter Study Conducted by Eric
Year: 2025
Type: article
Abstract: Autoimmune cytopenias (AIC) are a typical complication in chronic lymphocytic leukemia (CLL). The impact of venetoclax (ven)-based therapies on CLL-associated AIC is currently largely unknown. The aim of this multicenter study is to retrospectively evaluate in patients receiving ven-containing therapies 1) the characteristics and outcome of preexisting AIC, and 2) the incidence, quality and management of new onset, treatment-emergent AIC. Data from 1720 consecutive patients diagnosed with CLL and treated with ven-based regimens in 56 different centers were collected. Thirty-five% of patients were treatment-naïve (TN) and 65% were relapsed/refractory (RR). Treatments received by patients are depicted in Table 1. The median follow-up for the entire cohort was 21.8 months. A history of preexisting AIC was reported in 202 patients (12%), of whom 61% had autoimmune hemolytic anemia (AIHA), 36% immune thrombocytopenia (ITP), 2% pure red cell aplasia (PRCA) and 1% autoimmune granulocytopenia. Preexisting AIC was present in 9% of TN and 13% of RR patients (p=0.005). At treatment start, AIC was active in 40%, controlled in 20% and resolved in 40% of the patients. Ven-based treatment induced AIC resolution or improvement in 73% of patients with an active AIC, and in 45% of patients with a controlled AIC. Patients with or without preexisting AIC did not differ significantly in terms of CLL-associated genetic risk factors, progression-free survival and overall survival. Treatment-emergent, new onset AIC (46% AIHA, 51% ITP, 3% PRCA) occurred at a median time of 5.9 months from treatment start in 39/1518 patients (2.6%) (2% in TN patients and 2.9% in RR, NS). Specifically, AIC episodes were reported in 4.3% of patients treated with ven monotherapy and in 2.1% of those treated with a ven-based combination (p=0.02). Following AIC management, the episodes were considered resolved in 47% and controlled in 34% of patients, with no substantial differences between those treated with ven monotherapy versus ven combinations. In conclusion, ven-containing regimens have a beneficial impact on the outcome of preexisting autoimmune phenomena associated with CLL. Treatment-emergent AIC episodes tend to be rare and may be more frequent in patients treated with ven single-agent versus ven-based combinations, but these complications are successfully manageable in most patients.
Authors: C. Vitale, T. Chatzikonstantinou, C. Papaggelou, F. Perutelli, M.C. Montalbano, G. Bondielli, E. Boccellato, S. Alshemari, F. Angotzi, M. Arguello-Tomas, T. Arpas, S. Bašić-Kinda, S. Besikli-Dimou, Ł. Bołkun, T. Buczek, A. Butrym, S. Chatzileontiadou, R. Collado, R. Cordoba Mascuñano, L. De Paoli, M. Deodato, M. Dimou, D. Donaldson, J. Drozd-Sokołowska, S. Elias, A. Ferrario, A. Fresa, A.M. Frustaci, R. García-Serra, A. Gogia, I. González-Gascón-Y-Marín, V. Graklanov, M. Hryniewiecka, Z. Huayuan, E. Iskierka-Jażdżewska, P. Jablonowska-Babij, O. Jaksic, E. Kalicińska, M. Kislova, M. Koren-Michowitz, E. Koumpis, Z. Kubová, J. Labrador, P. Lauzzana, S. Levi, F. Martini, M. Mikhaleva, E. Minga, R. Moia, E. Morawiec-Szymonik, M. Morawska, F.V.M. Mulder, R. Murru, J. Olivieri, E. Paszkiewicz-Kozik, L. Rani, J.M. Roncero, W. Salamon, A. Sanna, L. Scarfò, T. Shokralla, M. Šimkovič, M. Škerget, E. Spasov, A. Tranidou, J. Tryc-Szponder, M. Varettoni, A. Visentin, G. Vrachiolias, D. Waddell, E. Wasik-Szczepanek, K. Wdowiak, M. Wilk, K. Wiśniewski, M. Witkowska, M. Yassin, S. Yıldız, K. Zielonka, N. Albiol, J.R. Brown, B. Bruno, M. Catherwood, A. Chatzidimitriou, M. Doubek, G. Gaidano, A. Gozzetti, R. Gupta, E. Hatzimichael, Y. Herishanu, K. Jamroziak, I. Kotsianidis, L. Laurenti, E. Nikitin, M. Papaioannou, T. Papajik, M. Špaček, N. Stavroyianni, J. Vos, T. Wróbel, M. Yağcı, A.P. Kater, M. Davids, P. Langerbeins, K. Stamatopoulos, P. Ghia, M. Coscia
Institutions: Azienda Ospedaliera Citta' della Salute e della Scienza di Torino, University of Turin, Centre for Research and Technology Hellas, Azienda Sanitaria Ospedaliera S.Croce e Carle Cuneo, Kuwait University, University of Padua, Universitat Autònoma de Barcelona, Hospital de Sant Pau, Josep Carreras Leukaemia Research Institute, Masaryk University, University Hospital Centre Zagreb, University of Zagreb, St George’s University Hospitals NHS Foundation Trust, Wroclaw Medical University, AHEPA University Hospital, Fundacio Investigacio Hospital General Universitari De Valencia, Hospital General Universitario De Valencia, Hospital Universitario Fundación Jiménez Díaz, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, National and Kapodistrian University of Athens, Laiko General Hospital of Athens, Belfast City Hospital, Medical University of Warsaw, Dana-Farber Cancer Institute, Ospedale di Circolo e Fondazione Macchi, Aziende Socio Sanitarie Territoriale dei Sette Laghi, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", All India Institute of Medical Sciences, Hospital Universitario Infanta Leonor, Medical University Plovdiv, Szpital Morski im. PCK, Jiangsu Province Hospital, Copernicus Memorial Hospital, Medical University of Lodz, University Hospital Dubrava, Botkin Hospital, Tel Aviv University, University of Ioannina, Palacký University Olomouc, Hospital Universitario de Burgos, Azienda sanitaria universitaria Friuli Centrale, Tel Aviv Sourasky Medical Center, Vita-Salute San Raffaele University, IRCCS Ospedale San Raffaele, Università degli Studi del Piemonte Orientale “Amedeo Avogadro”, Medical University of Lublin, Sanquin, The Maria Sklodowska-Curie National Research Institute of Oncology, Institut Català d'Oncologia, Institut d'Investigació Biomèdica de Girona, Hospital Universitari de Girona Doctor Josep Trueta, Azienda Ospedaliero-Universitaria Careggi, Charles University, General University Hospital in Prague, University Hospital Hradec Králové, University of Ljubljana, Ljubljana University Medical Centre, Poznan University of Medical Sciences, Policlinico San Matteo Fondazione, Democritus University of Thrace, University Hospital of Alexandroupolis, Medical University of Silesia, Szpital Uniwersytecki w Krakowie, Instytut Hematologii i Transfuzjologi, National Center for Cancer Care and Research, Gazi University, Central European Institute of Technology, Central European Institute of Technology – Masaryk University, University Hospital Brno, University of Siena, Università Cattolica del Sacro Cuore, Agostino Gemelli University Polyclinic, G. Papanikolaou General Hospital, Amsterdam University Medical Centers, Cancer Center Amsterdam, University of Amsterdam, University of Cologne, University Hospital Cologne, Deutsche CLL Studiengruppe (DCLLSG), University of Insubria
Language: English
Subfield: Genetics
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7094977342
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