Relapsed/refractory pure red cell aplasia in chronic lymphocytic leukemia successfully treated with acalabrutinib: a case report and review of the literature

The incidence of pure red cell aplasia (PRCA) in chronic lymphocytic leukemia (CLL) is <1% and treatments include the use of steroids and therapeutic strategies including immunosuppressive therapies. Here we present a case of a CLL-associated PRCA successfully treated with acalabrutinib, a treatment never described before for this specific condition, obtaining a rapid response after failing two lines of therapy. Exploring the treatment rationale, both the immune modulation and the continuous control of the disease, could have played a role in the treatment efficacy. Covalent BTK inhibitors are an effective treatment option for autoimmune complications of CLL, including CLL-associated PRCA.