Cosentyx

[eeebcll]

I have been on WW CLL for about ten years. With wbc ranging from 13 to 28. I recently started injecting Cosentyx for a bad case of psoriasis. I previously was diagnosed with rheumatoid arthritis and was taking lefludemide. My wbc is now down to 4 and am wondering if that is a result of Cosentyx. Has anyone had this drug impacting their wbc or am I just lucky?

[AussieNeil Administrator]

There is an overlap in drugs used to treat autoimmune conditions and CLL. If you reduce the B cell count or more specifically B cell activity in making antibodies that attack body cells, you can reduce the inflammation.

[LeoPa]

That is a dramatic reduction that got me interested. Do let us know please whether this trend continues. If you get cured incidentally 🤞 that would be great news.

[Big_Dee]

Hello eeebcll

Good question. I had psoriasis arthritis and had B+R CLL treatment. The Rituximab cleared my psoriasis and helped arthritis. Rituximab has been used for rheumatoid arthritis. Almost 5 years after B+R treatment my psoriasis is starting to come back. Would I do Rituximab again to get rid of psoriasis? No. Blessings.

[Vlaminck]

This post and the comments made me wonder what % of us CLL sufferers also have/have had some other autoimmune issue -- I have had, I think, psoriasitic (sp) arthritis, altho never definitively diagnosed (occasional pain and developed knots on index finger joints). Is psoriasis and/or rheumatoid arthritis possibly a precursor for CLL? Just thoughts floating in my head that this post triggered.

[NoClew]

Sharing my experience, while in a clinical trial on Acalabrutinib I suffered arthralgia, pain to the bone, and while trying to find a solution for me, my team shared that those with OA, lucky me, suffered the most. Yet those with RA were not bothered by the pain, even had some relief, to the point where they were studying the efficacy of using Ibrutinib to treat RA. I haven't heard if that went anywhere. On the subject of developing other autoimmune diseases, the consultant I saw at MDA warned me that when I started a BTKi, I would need a very good endocrinologist as the 'ibs' could run havoc with my metabolism. Acalabrutinib certainly did, and testing my thyroid antibodies proved that I had acquired Hashimotos disease, a thyroid autoimmune disorder, with all the trimmings including extreme fatigue, major weight gain, hair loss, splitting nails, lipids going haywire, etc. ??? Make of all this what you will. Wishing you soft landings.

[AussieNeil Administrator in reply to NoClew]

NoClew, eeebcll and Vlaminck , a 2020 paper and a CLL Support article from 2017 are of relevance here;

Autoimmune Complications in Chronic Lymphocytic Leukemia in the Era of Targeted Drugs (Published 2020)

2. Pathophysiology and Diagnostic Criteria for Autoimmune Cytopenias in CLL

The association between AIC and CLL has been described since the late 1960s [13]. Among AIC, autoimmune hemolytic anemia (AIHA) is by far the most common type, followed by immune thrombocytopenia (ITP), and their simultaneous or sequential association is defined as Evans syndrome. Pure red cell aplasia (PRCA) and autoimmune granulocytopenia (AIG) are definitely rarer. Major studies systematically evaluating the occurrence of AIC in patients with CLL are summarized in Table 1 and Figure 1.

ncbi.nlm.nih.gov/pmc/articl...

Autoimmune Problems in CLL (chronic lymphocytic leukemia) (Published 2017)

cllsociety.org/2017/04/auto...

Autoimmune Hemolytic Anemia (AIHA) is the most common

While prevalence data varies widely, and some studies suggest much higher numbers, probably about 7% of CLL patients have AIHA at some time in their disease.

Idiopathic thrombocytopenic purpura or immune thrombocytopenia (ITP)

ITP occurs less commonly, maybe in 2% of CLL patients.

Other Rare Hematologic Immune Problems:

Pure Red Cell Aplasia (PRCA) attacks the immature red blood cell precursors in the bone marrow and Evans Syndrome is where the unlucky patient’s red cells and platelets are both being destroyed. Fortunately these are rare conditions in CLL.

Unusual Autoimmune Issues in CLL:

Cases have been reported on patients with CLL developing antibody-related diseases affecting the skin, nerves, clotting factors, thyroid, joints and other organs, though in most cases there is little or no causal evidence.

Table 1 shows the varying proportion of autoimmune CLL complications from different papers