Case Report of a 60-Year-Old Woman with Autoimmune Hemolytic Anaemia after Venetoclax

Abstract

Background: Chronic Lymphocytic Leukaemia (CLL) is a common haematological malignant neoplasm that is characterized by proliferation of clonal B-cell lymphocytes and infiltration of blood, lymph nodes, spleen and bone marrow. Autoimmune Hemolytic Anaemia (AIHA) is a medical condition in which patient’s red blood cells are being destructed by immune system through antibodies leading to red blood cell lysis. Venetoclax is a novel BCL-2 selective inhibitor introduced amongst patients with CLL refractory to standard treatment lines. Common adverse events in Venetoclax treatment are: neutropenia, thrombocytopenia and diarrhea. Case Report: The following case study presents 60-year-old female patient that developed an autoimmune hemolytic anemia after introducing Venetoclax for CLL diagnosed nearly 13 years before and treated with many other treatment lines. AIHA was resolved after withdrawing Venetoclax and being treated with steroids, Rituximab and plasmapheresis. After that, Venetoclax was reintroduced with carefully monitored hemolysis markers as well as maintaining steroids and Rituximab treatment with good results. Conclusion: Although AIHA caused by Venetoclax is still not mentioned by producer’s summary of product characteristic (sPC), it is valuable for clinicians to have the knowledge that such adverse event may occur (diagnosed after eliminating other causes) and how it can be handled based on experiences of fellow clinicians.