Obinutuzumab in the treatment of autoimmune haemolytic anaemia and immune thrombocytopenia in patients with chronic lymphocytic leukaemia/small lymphocytic lymphoma.

Keywords: obinutuzumab; AIHA; ITP; CLL EN obinutuzumab AIHA ITP CLL e1 e4 4 12/21/20 20210101 NES 210101 Obinutuzumab is a type II, glycoengineered, humanized anti-CD20 monoclonal antibody, with enhanced direct cell death and antibody-dependent cell-mediated cytotoxicity.1 Obinutuzumab is FDA-approved for chronic lymphocytic leukaemia (CLL) in combination with chlorambucil, ibrutinib or venetoclax as a first-line treatment.2-4 Similar to rituximab, obinutuzumab induces B-cell depletion and reduced antibody production, granting it the potential to effectively treat antibody-mediated autoimmune phenomena. We report here a retrospective analysis of eight patients with CLL/small lymphocytic lymphoma (SLL) who were treated with single-agent obinutuzumab for autoimmune haemolytic anaemia (AIHA) or immune thrombocytopenia (ITP), from September 2018 to March 2020. Among our patients, the results achieved with obinutuzumab were especially impressive in a patient with ITP, resistant to multiple therapies, including splenectomy and rituximab, who rapidly responded to obinutuzumab. A prospective randomized trial comparing the efficacy of obinutuzumab and rituximab in the treatment of AIHA/ITP in patients with CLL/SLL, as well as the optimal duration of treatment (e.g. short-term obinutuzumab), is warranted. [Extracted from the article]