Intrinsic and treatment-related immune alterations in chronic lymphocytic leukaemia and their impact for clinical practice

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Abstract
Background: Chronic lymphocytic leukaemia patients harbour important impairments in both their cellular- and humoral-mediated immunity, which accounts for their notorious susceptibility to a multitude of infections and various autoimmune cytopenias. It has also been shown that the rate of second cancers is increased in chronic lymphocytic leukaemia. Objective: The aim of this study was to review the immune alterations in untreated and treated chronic lymphocytic leukaemia and define their impact for clinical practice. Methods: The author gives a comprehensive review of the most relevant preclinical and clinical studies pertaining to various immune abnormalities and infectious complications in both untreated and treated chronic lymphocytic leukaemia. Landmark clinical trials involving the contemporary chronic lymphocytic leukaemia chemo- and immunotherapies, alone or in combination, as well as the main epidemiological studies establishing the increased rate of second cancers in chronic lymphocytic leukaemi...