Venetoclax therapy improved or controlled CLL-associated autoimmune cytopenias in retrospective study

This retrospective multicenter study evaluated preexisting and treatment-emergent autoimmune cytopenias (AIC) among 1,720 patients with chronic lymphocytic leukemia (CLL) treated with venetoclax. Venetoclax was given as monotherapy in 23.1% of patients and in combination regimens in 76.9%; combinations were more common in treatment-naïve than in relapsed or refractory disease.

Preexisting AIC were reported in 11.7% of patients, including 8.7% of treatment-naïve and 13.4% of relapsed or refractory patients. Regardless of regimen, AIC resolved or improved in 63% of patients with active or controlled preexisting AIC. Treatment-emergent AIC occurred in 2.6% overall: 4.3% with monotherapy versus 2.1% with combinations (P=0.02). After standard management, AIC was resolved or controlled in 82% of affected patients.

The higher unadjusted frequency with monotherapy was attenuated after adjustment for baseline prognostic factors. The findings suggest that treatment-emergent AIC is uncommon and generally manageable, but the retrospective design limits conclusions about comparative effects of monotherapy and combinations.