Autoimmune cytopenia in chronic lymphocytic leukemia: diagnosis and treatment
Summary. The aim of the study was to determine peculiarities of the distribution, diagnosis and development of immune cytopenias in patients with chronic lymphocytic leukemia (CLL) and to evaluate the efficacy of the different therapeutic approaches. Materials and Methods: Treatment response and sur...
Gespeichert in:
| Datum: | 2023 |
|---|---|
| Hauptverfasser: | , , , , , , , |
| Format: | Artikel |
| Sprache: | Englisch |
| Veröffentlicht: |
PH Akademperiodyka
2023
|
| Schlagworte: | |
| Online Zugang: | https://exp-oncology.com.ua/index.php/Exp/article/view/2020-4-14 |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| Назва журналу: | Experimental Oncology |
Institution
Experimental Oncology| _version_ | 1856543487336382464 |
|---|---|
| author | Yevstakhevych, Yu.L. Vyhovska, Ya.I. Yevstakhevyc, I.Y. Vyhovsk, O.Y. Pelenyo, N.V. Semerak, M.M. Novak, V.L. Loginsky, V.E. |
| author_facet | Yevstakhevych, Yu.L. Vyhovska, Ya.I. Yevstakhevyc, I.Y. Vyhovsk, O.Y. Pelenyo, N.V. Semerak, M.M. Novak, V.L. Loginsky, V.E. |
| author_sort | Yevstakhevych, Yu.L. |
| baseUrl_str | |
| collection | OJS |
| datestamp_date | 2023-10-11T16:43:48Z |
| description | Summary. The aim of the study was to determine peculiarities of the distribution, diagnosis and development of immune cytopenias in patients with chronic lymphocytic leukemia (CLL) and to evaluate the efficacy of the different therapeutic approaches. Materials and Methods: Treatment response and survival of 83 patients with CLL complicated by immune cytopenia (IC) were analyzed. Treatment schedules in 58 medicated patients included corticosteroids; chemotherapy (COP, CHOP regimens), immunotherapy (rituximab alone), immunochemotherapy (rituximab-containing regimens — R-COP, R-CHOP). Twenty-five patients underwent splenectomy. Results: The use of corticosteroids, as the first line of treatment, resulted in short-term remission in most patients. Chemotherapy was effective in a half of CLL patients, but duration of the remission did not exceed 32 months in CLL associated with autoimmune hemolytic anemia and immune thrombocytopenia. After rituximab monotherapy (10 patients) the stable remission was reached in 60% of the patients with median relapse-free survival of 40 months. Rituximab containing chemotherapy (22 patients) caused the long-term remission in 72% of the patients with median relapse-free survival of 76 months. Splenectomy performed in 25 patients with CLL complicated by IC was effective in 70% of the patients. The outcome of splenectomy depends on IC entity. The best response was registered in associated immune thrombocytopenia (median overall survival 118 months), the worst — in Fisher — Evans syndrome (15 months). Conclusions: The treatment of patients with CLL complicated by ICs should be individualized. For CLL patients without significant enlargement of lymph nodes and spleen, low lymphocytosis, associated with autoimmune hemolytic anemia or immune thrombocytopenia, the monotherapy with rituximab is optimal. In case of occurrence of autoimmune hemolytic anemia, immune thrombocytopenia or Fisher — Evans syndrome in CLL patients with enlargement of lymph nodes, spleen, significant lymphocytosis, the use of R-COP or R-CHOP schemes, 4–6 courses, is the most effective. Splenectomy is indicated in patients with massive splenomegaly, the resistance to medication, recurrent relapses after adequate therapy. |
| first_indexed | 2025-07-17T12:15:57Z |
| format | Article |
| id | oai:ojs2.ex.aqua-time.com.ua:article-159 |
| institution | Experimental Oncology |
| language | English |
| last_indexed | 2025-07-17T12:15:57Z |
| publishDate | 2023 |
| publisher | PH Akademperiodyka |
| record_format | ojs |
| spelling | oai:ojs2.ex.aqua-time.com.ua:article-1592023-10-11T16:43:48Z Autoimmune cytopenia in chronic lymphocytic leukemia: diagnosis and treatment Autoimmune cytopenia in chronic lymphocytic leukemia: diagnosis and treatment Yevstakhevych, Yu.L. Vyhovska, Ya.I. Yevstakhevyc, I.Y. Vyhovsk, O.Y. Pelenyo, N.V. Semerak, M.M. Novak, V.L. Loginsky, V.E. autoimmune hemolytic anemia, chemotherapy, chronic lymphocytic leukemia, Fisher — Evans syndrome, immune thrombocytopenia, rituximab, splenectomy autoimmune hemolytic anemia, chemotherapy, chronic lymphocytic leukemia, Fisher — Evans syndrome, immune thrombocytopenia, rituximab, splenectomy Summary. The aim of the study was to determine peculiarities of the distribution, diagnosis and development of immune cytopenias in patients with chronic lymphocytic leukemia (CLL) and to evaluate the efficacy of the different therapeutic approaches. Materials and Methods: Treatment response and survival of 83 patients with CLL complicated by immune cytopenia (IC) were analyzed. Treatment schedules in 58 medicated patients included corticosteroids; chemotherapy (COP, CHOP regimens), immunotherapy (rituximab alone), immunochemotherapy (rituximab-containing regimens — R-COP, R-CHOP). Twenty-five patients underwent splenectomy. Results: The use of corticosteroids, as the first line of treatment, resulted in short-term remission in most patients. Chemotherapy was effective in a half of CLL patients, but duration of the remission did not exceed 32 months in CLL associated with autoimmune hemolytic anemia and immune thrombocytopenia. After rituximab monotherapy (10 patients) the stable remission was reached in 60% of the patients with median relapse-free survival of 40 months. Rituximab containing chemotherapy (22 patients) caused the long-term remission in 72% of the patients with median relapse-free survival of 76 months. Splenectomy performed in 25 patients with CLL complicated by IC was effective in 70% of the patients. The outcome of splenectomy depends on IC entity. The best response was registered in associated immune thrombocytopenia (median overall survival 118 months), the worst — in Fisher — Evans syndrome (15 months). Conclusions: The treatment of patients with CLL complicated by ICs should be individualized. For CLL patients without significant enlargement of lymph nodes and spleen, low lymphocytosis, associated with autoimmune hemolytic anemia or immune thrombocytopenia, the monotherapy with rituximab is optimal. In case of occurrence of autoimmune hemolytic anemia, immune thrombocytopenia or Fisher — Evans syndrome in CLL patients with enlargement of lymph nodes, spleen, significant lymphocytosis, the use of R-COP or R-CHOP schemes, 4–6 courses, is the most effective. Splenectomy is indicated in patients with massive splenomegaly, the resistance to medication, recurrent relapses after adequate therapy. Summary. The aim of the study was to determine peculiarities of the distribution, diagnosis and development of immune cytopenias in patients with chronic lymphocytic leukemia (CLL) and to evaluate the efficacy of the different therapeutic approaches. Materials and Methods: Treatment response and survival of 83 patients with CLL complicated by immune cytopenia (IC) were analyzed. Treatment schedules in 58 medicated patients included corticosteroids; chemotherapy (COP, CHOP regimens), immunotherapy (rituximab alone), immunochemotherapy (rituximab-containing regimens — R-COP, R-CHOP). Twenty-five patients underwent splenectomy. Results: The use of corticosteroids, as the first line of treatment, resulted in short-term remission in most patients. Chemotherapy was effective in a half of CLL patients, but duration of the remission did not exceed 32 months in CLL associated with autoimmune hemolytic anemia and immune thrombocytopenia. After rituximab monotherapy (10 patients) the stable remission was reached in 60% of the patients with median relapse-free survival of 40 months. Rituximab containing chemotherapy (22 patients) caused the long-term remission in 72% of the patients with median relapse-free survival of 76 months. Splenectomy performed in 25 patients with CLL complicated by IC was effective in 70% of the patients. The outcome of splenectomy depends on IC entity. The best response was registered in associated immune thrombocytopenia (median overall survival 118 months), the worst — in Fisher — Evans syndrome (15 months). Conclusions: The treatment of patients with CLL complicated by ICs should be individualized. For CLL patients without significant enlargement of lymph nodes and spleen, low lymphocytosis, associated with autoimmune hemolytic anemia or immune thrombocytopenia, the monotherapy with rituximab is optimal. In case of occurrence of autoimmune hemolytic anemia, immune thrombocytopenia or Fisher — Evans syndrome in CLL patients with enlargement of lymph nodes, spleen, significant lymphocytosis, the use of R-COP or R-CHOP schemes, 4–6 courses, is the most effective. Splenectomy is indicated in patients with massive splenomegaly, the resistance to medication, recurrent relapses after adequate therapy. PH Akademperiodyka 2023-05-30 Article Article application/pdf https://exp-oncology.com.ua/index.php/Exp/article/view/2020-4-14 10.32471/exp-oncology.2312-8852.vol-42-no-4.15505 Experimental Oncology; Vol. 42 No. 4 (2020): Experimental Oncology; 318-323 Експериментальна онкологія; Том 42 № 4 (2020): Експериментальна онкологія; 318-323 2312-8852 1812-9269 10.32471/exp-oncology.2312-8852.vol-42-no-4 en https://exp-oncology.com.ua/index.php/Exp/article/view/2020-4-14/2020-4-14 Copyright (c) 2023 Experimental Oncology https://creativecommons.org/licenses/by-nc/4.0/ |
| spellingShingle | autoimmune hemolytic anemia chemotherapy chronic lymphocytic leukemia Fisher — Evans syndrome immune thrombocytopenia rituximab splenectomy Yevstakhevych, Yu.L. Vyhovska, Ya.I. Yevstakhevyc, I.Y. Vyhovsk, O.Y. Pelenyo, N.V. Semerak, M.M. Novak, V.L. Loginsky, V.E. Autoimmune cytopenia in chronic lymphocytic leukemia: diagnosis and treatment |
| title | Autoimmune cytopenia in chronic lymphocytic leukemia: diagnosis and treatment |
| title_alt | Autoimmune cytopenia in chronic lymphocytic leukemia: diagnosis and treatment |
| title_full | Autoimmune cytopenia in chronic lymphocytic leukemia: diagnosis and treatment |
| title_fullStr | Autoimmune cytopenia in chronic lymphocytic leukemia: diagnosis and treatment |
| title_full_unstemmed | Autoimmune cytopenia in chronic lymphocytic leukemia: diagnosis and treatment |
| title_short | Autoimmune cytopenia in chronic lymphocytic leukemia: diagnosis and treatment |
| title_sort | autoimmune cytopenia in chronic lymphocytic leukemia: diagnosis and treatment |
| topic | autoimmune hemolytic anemia chemotherapy chronic lymphocytic leukemia Fisher — Evans syndrome immune thrombocytopenia rituximab splenectomy |
| topic_facet | autoimmune hemolytic anemia chemotherapy chronic lymphocytic leukemia Fisher — Evans syndrome immune thrombocytopenia rituximab splenectomy autoimmune hemolytic anemia chemotherapy chronic lymphocytic leukemia Fisher — Evans syndrome immune thrombocytopenia rituximab splenectomy |
| url | https://exp-oncology.com.ua/index.php/Exp/article/view/2020-4-14 |
| work_keys_str_mv | AT yevstakhevychyul autoimmunecytopeniainchroniclymphocyticleukemiadiagnosisandtreatment AT vyhovskayai autoimmunecytopeniainchroniclymphocyticleukemiadiagnosisandtreatment AT yevstakhevyciy autoimmunecytopeniainchroniclymphocyticleukemiadiagnosisandtreatment AT vyhovskoy autoimmunecytopeniainchroniclymphocyticleukemiadiagnosisandtreatment AT pelenyonv autoimmunecytopeniainchroniclymphocyticleukemiadiagnosisandtreatment AT semerakmm autoimmunecytopeniainchroniclymphocyticleukemiadiagnosisandtreatment AT novakvl autoimmunecytopeniainchroniclymphocyticleukemiadiagnosisandtreatment AT loginskyve autoimmunecytopeniainchroniclymphocyticleukemiadiagnosisandtreatment |