Autoimmune cytopenias in chronic lymphocytic leukemia in the era of novel drugs.

Abstract

IntroductionAutoimmune cytopenias are common complications of chronic lymphocytic leukemia, leading to increased morbidity and a reduced quality of life for affected patients. The diagnosis and management of these complications have improved with the development of new therapeutic agents for chronic lymphocytic leukemia. Areas coveredThis review summarizes the key findings on diagnosing and managing autoimmune cytopenias in patients with chronic lymphocytic leukemia, with a particular focus on the impact of new therapeutic agents. These include Bruton tyrosine kinase inhibitors, B-cell lymphoma 2 protein inhibitors, monoclonal and bispecific antibodies, phosphatidylinositol 3-kinase inhibitors, and chimeric antigen receptor T-cell therapies.Expert opinionDespite advances in the treatment of autoimmune cytopenias, current management still primarily relies on corticosteroid therapy. Clear evidence supporting the use of novel targeted agents in this setting remains limited. Future progress depends on dedicated clinical trials aimed at better defining the role of emerging therapies and enabling more personalized treatment strategies, although the rarity of autoimmune cytopenias associated with chronic lymphocytic leukemia presents a significant challenge.