title: Autoimmune cytopenias in chronic lymphocytic leukemia.
abstract: The clinical course of chronic lymphocytic leukemia (CLL) may be complicated at any time by autoimmune phenomena.The most common ones are hematologic disorders, such as autoimmune hemolytic anemia (AIHA) and immune thrombocytopenia (ITP). Pure red cell aplasia (PRCA) and autoimmune agranulocytosis (AG) are, indeed, more rarely seen. However, they are probably underestimated due to the possible misleading presence of cytopenias secondary to leukemic bone marrow involvement or to chemotherapy cytotoxicity. The source of autoantibodies is still uncertain, despite the most convincing data are in favor of the involvement of resting normal B-cells. In general, excluding the specific treatment of underlying CLL, the managementof these complications is not different from that of idiopathic autoimmune cytopenias or of those associated to other causes. Among different therapeutic approaches, monoclonal antibody rituximab, given alone or in combination, has shown to be very effective.
authors.affiliation: Onco-Hematology Department, IRCCS Centro di Riferimento Oncologico della Basilicata, 85028 Rionero in Vulture, Italy. giovannidarena@libero.it
authors.forename: Giovanni
authors.initials: G
authors.lastname: D'Arena
authors.forename: Roberto
authors.initials: R
authors.lastname: Guariglia
authors.forename: Francesco
authors.initials: F
authors.lastname: La Rocca
authors.forename: Stefania
authors.initials: S
authors.lastname: Trino
authors.forename: Valentina
authors.initials: V
authors.lastname: Condelli
authors.forename: Laura
authors.initials: L
authors.lastname: De Martino
authors.forename: Vincenzo
authors.initials: V
authors.lastname: De Feo
authors.forename: Pellegrino
authors.initials: P
authors.lastname: Musto
mesh_terms: D000380:Agranulocytosis / Q000150:complications / Q000188:drug therapy / Q000276:immunology* / Q000473:pathology; D000744:Anemia, Hemolytic, Autoimmune / Q000150:complications / Q000188:drug therapy / Q000276:immunology* / Q000473:pathology; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D001323:Autoantibodies / Q000276:immunology; D015551:Autoimmunity; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000150:complications / Q000188:drug therapy / Q000276:immunology* / Q000473:pathology; D012010:Red-Cell Aplasia, Pure / Q000150:complications / Q000188:drug therapy / Q000276:immunology* / Q000473:pathology; D000069283:Rituximab; D013921:Thrombocytopenia / Q000150:complications / Q000188:drug therapy / Q000276:immunology* / Q000473:pathology
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D001323:Autoantibodies; D007155:Immunologic Factors; D000069283:Rituximab