Long-term immune changes in patients with relapsed/refractory chronic lymphocytic leukemia following treatment with venetoclax plus rituximab

Kater, AP; Eichhorst, BF; Owen, CJ; Jaeger, U; Chyla, B; Lefebure, M; Millen, R; Jiang, Y; Thadani-Mulero, M; Boyer, M; Seymour, JF

Author(s): Kater, AP; Eichhorst, BF; Owen, CJ; Jaeger, U; Chyla, B; Lefebure, M; Millen, R; Jiang, Y; Thadani-Mulero, M; Boyer, M; Seymour, JF;
Details: Publication Year 2024-08,Volume 8,Issue #8,Page e146
Journal Title: Hemasphere
Publication Type: Research article
Abstract: Immune dysregulation is a hallmark of chronic lymphocytic leukemia (CLL). Anti-CD20 antibodies (e.g., rituximab [R]) can be combined with venetoclax (Ven) to treat CLL. However, anti-CD20 antibodies can increase hypogammaglobulinemia risk, while the effects of Ven on immune dysregulation are still uncertain. We report long-term immune changes in VenR- and bendamustine-R (BR)-treated patients with relapsed/refractory CLL in the MURANO trial (NCT02005471). Patients were randomized to fixed-duration VenR (2 years Ven; VenR for the first 6 months) or BR (6 months). Immune cell levels were evaluated at the end of combination treatment (EOCT), end of treatment (EOT; VenR arm only), and 12 and 24 months post-EOCT. Overall, 130/194 VenR- and 134/195 BR-treated patients completed treatment without progressive disease. In patients who completed VenR combination therapy, median immunoglobulin (Ig)G and IgM levels decreased from baseline to EOT (p ≤ 0.01 and p ≤ 0.0001, respectively); by 24 months, post-EOT IgG had returned to baseline level and IgM had increased from baseline (p ≤ 0.001). Median IgA levels increased from baseline to 12 (p ≤ 0.0001) and 24 months post-EOT (p ≤ 0.0001). In BR-treated patients, changes in IgG, IgA, and IgM levels across the assessed time points were not significant, and by 24 months, post-EOCT IgG, IgA, and IgM were above baseline levels. Grade ≥3 infection rates on treatment were low. Overall, immune recovery was observed with VenR and BR, with stabilization of Ig levels after treatment. Post-treatment infection rates were generally low, making these very tolerable therapies for CLL.
Publisher: Wiley
Department(s): Clinical Haematology
Publisher's Version: https://doi.org/10.1002/hem3.146
Open Access at Publisher's Site: https://doi.org/10.1002/hem3.146
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2024-09-12 06:44:29

Last Modified: 2024-09-12 06:49:54