C039 | IMPACT OF VENETOCLAX-BASED THERAPIES ON AUTOIMMUNE CYTOPENIAS IN PATIENTS WITH CHRONIC LYMPHOCYTIC LEUKEMIA: FINAL ANALYSIS OF A MULTICENTER STUDY CONDUCTED BY ERIC

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.

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SHILAP Revista de lepidopterología
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2025-09-01
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Chronic Lymphocytic Leukemia Research
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C039 | IMPACT OF VENETOCLAX-BASED THERAPIES ON AUTOIMMUNE CYTOPENIAS IN PATIENTS WITH CHRONIC LYMPHOCYTIC LEUKEMIA: FINAL ANALYSIS OF A MULTICENTER STUDY CONDUCTED BY ERIC

SHILAP Revista de lepidopterología
Chronic Lymphocytic Leukemia Research
article

C039 | IMPACT OF VENETOCLAX-BASED THERAPIES ON AUTOIMMUNE CYTOPENIAS IN PATIENTS WITH CHRONIC LYMPHOCYTIC LEUKEMIA: FINAL ANALYSIS OF A MULTICENTER STUDY CONDUCTED BY ERIC

article en

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.

SHILAP Revista de lepidopterología
University of Siena (IT), University of Insubria (IT), Poznan University of Medical Sciences (PL), Medical University of Lublin (PL), Tufts University (US), Università degli Studi del Piemonte Orientale “Amedeo Avogadro” (IT), Central European Institute of Technology (CZ), St. George's University (GD), University of Padua (IT), University of Ulster (GB), University Hospital Centre Zagreb (HR), Democritus University of Thrace (GR), Tel Aviv University (IL), Medical University of Silesia (PL), University of Zagreb (HR), University of Ioannina (GR), National and Kapodistrian University of Athens (GR), Charles University (CZ), Masaryk University (CZ), Medical University of Warsaw (PL), Tel Aviv Sourasky Medical Center (IL), University Hospital Dubrava (HR), AHEPA University Hospital (GR), Medical University Plovdiv (BG), Ljubljana University Medical Centre (SI), Ospedale di Circolo e Fondazione Macchi (IT), Hospital de Sant Pau (ES), Agostino Gemelli University Polyclinic (IT), Belfast City Hospital (GB), Sanquin (NL), Kuwait University (KW), Wroclaw Medical University (PL), Azienda Ospedaliera Citta' della Salute e della Scienza di Torino (IT), Düsseldorf University Hospital (DE), Josep Carreras Leukaemia Research Institute (ES), Central European Institute of Technology – Masaryk University (CZ), Cracow University of Technology (PL), Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda (IT), Integrated Oncology (United States) (US), Red Cross Hospital (GR), Copernicus Memorial Hospital (PL), Institut d'Investigació Biomèdica de Girona (ES), Assaf Harofeh Medical Center (IL), Laiko General Hospital of Athens (GR), Azienda Ospedaliero-Universitaria Careggi (IT), Hospital Universitario de Burgos (ES), Dana-Farber Cancer Institute (US), National Center for Cancer Care and Research (QA), University Multipurpose Hospital for Active Treatment "Sveti Georgi" (BG), National Institute of Oncology (HU), Botkin Hospital (RU), Medical University of Lodz (PL), Chemotherapy Foundation (US), Hospital General Universitario De Valencia (ES), Hospital Universitario Fundación Jiménez Díaz (ES), IRCCS Ospedale San Raffaele (IT), Centre for Research and Technology Hellas (GR), Wroclaw University of Health and Sport Sciences (PL), University Hospital Hradec Králové (CZ), Azienda Sanitaria Ospedaliera S.Croce e Carle Cuneo (IT), Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale" (IT), Policlinico San Matteo Fondazione (IT), Amsterdam University Medical Centers (NL), Jiangsu Province Hospital (CN), Istituti di Ricovero e Cura a Carattere Scientifico (IT), University Hospital Cologne (DE), Oncology Hematology Care (US), Hospital Universitari de Girona Doctor Josep Trueta (ES), G. Papanikolaou General Hospital (GR), General University Hospital in Prague (CZ), Hospital Universitario Infanta Leonor (ES), Azienda Ospedaliera G. Brotzu (IT), Heinrich Heine University Düsseldorf (DE), All India Institute of Medical Sciences (IN), Palacký University Olomouc (CZ), Nanjing Medical University (CN), Gazi University (TR)
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Chronic Lymphocytic Leukemia Research
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