Autoimmune cytopenias in chronic lymphocytic leukemia

Am J Hematol. 2014 Nov;89(11):1055-62. doi: 10.1002/ajh.23785. Epub 2014 Jul 7.

Abstract

Chronic lymphocytic leukemia (CLL) is frequently complicated by secondary autoimmune cytopenias (AIC) represented by autoimmune hemolytic anemia (AIHA), immune thrombocytopenia (ITP), pure red cell aplasia, and autoimmune granulocytopenia. The distinction of immune cytopenias from cytopenias due to bone marrow infiltration, usually associated with a worse outcome and often requiring a different treatment, is mandatory. AIHA and ITP are more frequently found in patients with unfavorable biological risk factors for CLL. AIC secondary to CLL respond less favorably to standard treatments than their primary forms, and treating the underlying CLL with chemotherapy or monoclonal antibodies may ultimately be necessary.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Agranulocytosis / blood
  • Agranulocytosis / diagnosis
  • Agranulocytosis / etiology*
  • Agranulocytosis / therapy
  • Anemia, Hemolytic, Autoimmune / blood
  • Anemia, Hemolytic, Autoimmune / diagnosis
  • Anemia, Hemolytic, Autoimmune / etiology*
  • Anemia, Hemolytic, Autoimmune / therapy
  • Antigen Presentation
  • Autoantibodies / immunology
  • Blood Cells / immunology
  • Blood Component Transfusion
  • Clone Cells / immunology
  • Combined Modality Therapy
  • Humans
  • Immunoglobulin G / immunology
  • Immunoglobulin Heavy Chains / genetics
  • Immunoglobulin M / immunology
  • Immunosuppressive Agents / therapeutic use
  • Leukemia, Lymphocytic, Chronic, B-Cell / complications*
  • Leukemia, Lymphocytic, Chronic, B-Cell / drug therapy
  • Leukemia, Lymphocytic, Chronic, B-Cell / immunology
  • Models, Immunological
  • Neoplastic Stem Cells / immunology
  • Paraneoplastic Syndromes / blood
  • Paraneoplastic Syndromes / diagnosis
  • Paraneoplastic Syndromes / etiology*
  • Paraneoplastic Syndromes / therapy
  • Prognosis
  • Purpura, Thrombocytopenic, Idiopathic / blood
  • Purpura, Thrombocytopenic, Idiopathic / diagnosis
  • Purpura, Thrombocytopenic, Idiopathic / etiology*
  • Purpura, Thrombocytopenic, Idiopathic / therapy
  • Receptors, Antigen, B-Cell / immunology
  • Red-Cell Aplasia, Pure / blood
  • Red-Cell Aplasia, Pure / diagnosis
  • Red-Cell Aplasia, Pure / etiology*
  • Red-Cell Aplasia, Pure / therapy
  • Risk Factors
  • Splenectomy
  • T-Lymphocyte Subsets / immunology

Substances

  • Adrenal Cortex Hormones
  • Autoantibodies
  • Immunoglobulin G
  • Immunoglobulin Heavy Chains
  • Immunoglobulin M
  • Immunosuppressive Agents
  • Receptors, Antigen, B-Cell