# Autoimmune Complications of Lymphoproliferative Diseases

## TL;DR

Autoimmune complications like anemia and thrombocytopenia can occur in certain lymphoproliferative diseases, and treatment strategies depend on the disease's activity and response to therapy.

## Contribution

The paper highlights the overlap in treatment approaches between lymphoproliferative diseases and autoimmune cytopenias due to shared pathogenic mechanisms.

## Key findings

- Autoimmune hemolytic anemia and immune thrombocytopenia are the most common complications in lymphoproliferative diseases.
- Systemic lupus erythematosus and rheumatoid arthritis are less frequently reported autoimmune complications.
- B-cell and T-cell therapies for lymphoproliferative diseases are also used in treating autoimmune cytopenias.

## Abstract

Peripheral autoimmune cytopenias may complicate a fraction of lymphoproliferative disorders (LPD), particularly chronic lymphocytic leukemia, non‐Hodgkin B‐cell lymphomas, angioimmunoblastic T‐cell lymphoma and large granular lymphocytic leukemia. The most frequent complications are autoimmune hemolytic anemia and immune thrombocytopenia, followed by pure red cell aplasia, autoimmune neutropenia and other systemic/organ specific autoimmune diseases. The latter are less frequently reported and probably underdiagnosed, and include systemic lupus erythematosus, rheumatoid arthritis, Sjögren's syndrome, antiphospholipid syndrome and disorders of the hemostatic system. Therapy is mainly directed at the specific autoimmune complication when it arises in the context of a non‐active LPD. However, autoimmune complications that are refractory to first line therapy usually require an LPD‐directed treatment. Of note, several B‐cell and T cell directed therapies that are used in LPD are also indicated or in trials for primary autoimmune cytopenias, underlying the overlapping pathogenic mechanisms between LPD and autoimmunity.