Impact of venetoclax‐based therapies on CLL‐associated autoimmune cytopenias: A retrospective study conducted by ERIC
Year: 2026
Type: article
Study design: Observational Study
Abstract: The impact of venetoclax-based therapies on autoimmune cytopenias (AIC) in patients with chronic lymphocytic leukemia (CLL) is largely unknown. This study aimed to evaluate preexisting and treatment-emergent AIC in patients with CLL treated with venetoclax, focusing on the differential impact of venetoclax monotherapy versus venetoclax-based combinations. In this retrospective multicenter study, data from 1720 patients were collected; 23.1% received venetoclax single agent and 76.9% venetoclax combinations (mostly containing anti-CD20 monoclonal antibodies and/or BTK inhibitors). Combination regimens were used in 97.7% of treatment-naïve (TN) patients and 65.8% of patients with relapsed/refractory (R/R) CLL. Preexisting AIC were reported in 11.7% of patients (8.7% in TN and 13.4% in R/R, P = 0.005). CLL-related genetic risk factors and disease outcomes did not differ in patients with and without preexisting AIC. Irrespective of treatment type, venetoclax therapy resulted in AIC resolution or improvement in 63% of patients with active or controlled AIC. Treatment-emergent AIC occurred in 2.6% of patients (2% in TN and 2.9% in R/R, not statistically significant). AIC episodes were reported in 4.3% of patients treated with venetoclax monotherapy and in 2.1% of those treated with venetoclax-based combinations (P = 0.02). After standard management, AIC was considered resolved or controlled in 82% of the patients, with no substantial difference between treatment groups. Venetoclax-based therapies have a beneficial impact on the outcome of CLL-associated preexisting AIC. Treatment-emergent AIC is a rare and generally manageable event. Although more frequent with venetoclax monotherapy in unadjusted analysis, this association was attenuated after adjustment for baseline prognostic factors.
Source: HemaSphere
DOI: 10.1002/hem3.70522
Authors: Candida Vitale, Thomas Chatzikonstantinou, Christina Papangelou, Francesca Perutelli, Maria Chiara Montalbano, Giulia Bondielli, Elia Boccellato, Salem Alshemmari, Francesco Angotzi, Miguel Arguello‐Tomas, Tomas Arpas, Sandra Bašić‐Kinda, Sotiria Besikli‐Dimou, Łukasz Bołkun, Tomasz Buczek, Aleksandra Butrym, Katherine Chapis, Sofia Chatzileontiadou, Rosa Collado, Raul Cordoba Mascuñano, Lorenzo De Paoli, Marina Deodato, Maria Dimou, David Donaldson, Joanna Drozd‐Sokołowska, Salem Elias, Andrea Ferrario, Alberto Fresa, Anna Maria Frustaci, Rocío García‐Serra, Ajay Gogia, Isabel González‐Gascón‐y‐Marín, Vasko Graklanov, Maria Hryniewiecka, Zhu Huayuan, Elzbieta Iskierka‐Jażdżewska, Paula Jablonowska‐Babij, Ozren Jaksic, Elzbieta Kalicińska, Maria Kislova, Maya Koren‐Michowitz, Epameinondas Koumpis, Zuzana Kubová, Jorge Labrador, Pietro Lauzzana, Shai Levi, Francesca Martini, Mariia Mikhaleva, Eva Minga, Riccardo Moia, Elżbieta Morawiec‐Szymonik, Marta Morawska, Femke V. M. Mulder, Roberta Murru, Jacopo Olivieri, Ewa Paszkiewicz‐Kozik, Lata Rani, Josep Maria Roncero, Wojciech Salamon, Alessandro Sanna, Lydia Scarfò, Tereza Shokralla, Martin Šimkovič, Matevž Škerget, Emil Spasov, Antigoni Tranidou, Jagoda Tryc‐Szponder, Marzia Varettoni, Andrea Visentin, George Vrachiolias, David Waddell, Ewa Wasik‐Szczepanek, Kamil Wdowiak, Mateusz Wilk, Kamil Wiśniewski, Magdalena Witkowska, Mohamed Yassin, Seyma Yıldız, Klaudia Zielonka, Nil Albiol, Jennifer R. Brown, Benedetto Bruno, Mark Catherwood, Anastasia Chatzidimitriou, Michael Doubek, Gianluca Gaidano, Alessandro Gozzetti, Ritu Gupta, Eleftheria Hatzimichael, Yair Herishanu, Krzysztof Jamroziak, Ioannis Kotsianidis, Luca Laurenti, Eugene Nikitin, Maria Papaioannou, Tomáš Papajik, Martin Špaček, Niki Stavroyianni, Josephine M. I. Vos, Tomasz Wróbel, Münci Yağcı, Arnon P. Kater, Matthew Davids, Petra Langerbeins, Kostas Stamatopoulos, Paolo Ghia, Marta 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, Institut de Recerca Sant Pau, Masaryk University, University Hospital Brno, University Hospital Centre Zagreb, St George's Hospital, Medical University of Białystok, University Clinical Hospital In Bialystok, University of Wrocław, Wroclaw Medical University, Dana-Farber Cancer Institute, AHEPA University Hospital, 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, Ospedale di Circolo e Fondazione Macchi, Aziende Socio Sanitarie Territoriale dei Sette Laghi, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", DR. B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Hospital Universitario Infanta Leonor, University Multipurpose Hospital for Active Treatment "Sveti Georgi", Szpital Morski im. PCK, Jiangsu Province Hospital, Copernicus Memorial Hospital, Medical University of Lodz, University Hospital Dubrava, Russian Medical Academy of Continuous Professional Education, Botkin Hospital, Tel Aviv University, Assaf Harofeh Medical Center, University of Ioannina, University Hospital Olomouc, Palacký University Olomouc, Hospital Universitario de Burgos, Azienda sanitaria universitaria Friuli Centrale, Tel Aviv Sourasky Medical Center, IRCCS Ospedale San Raffaele, Università degli Studi del Piemonte Orientale “Amedeo Avogadro”, Azienda Ospedaliero Universitaria Maggiore della Carita, Medical University of Lublin, Amsterdam UMC Location University of Amsterdam, Sanquin, Amsterdam University Medical Centers, University of Amsterdam, Azienda Ospedaliera G. Brotzu, 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, Vita-Salute San Raffaele University, Charles University, University Hospital Hradec Králové, University of Ljubljana, Ljubljana University Medical Centre, Medical University Plovdiv, Poznan University of Medical Sciences, Policlinico San Matteo Fondazione, Democritus University of Thrace, University Hospital of Alexandroupolis, Medical University of Silesia, 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 of Siena, Università Cattolica del Sacro Cuore, Agostino Gemelli University Polyclinic, G. Papanikolaou General Hospital, Cancer Center Amsterdam, University of Cologne, University Hospital Cologne, Deutsche CLL Studiengruppe (DCLLSG), University of Insubria
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,480
OpenAlex ID: W7225408441