Autoimmune-mediated hemotoxicities

The introduction of biotherapeutics opened a new era of treatment for several inflammatory and cancer diseases, although they are not deprived in toxicity, which can lead to drug interruption. Besides infusion reactions, the occurrence of cytopenia is a major concern regarding treatment with biologicals. Biotherapeutic-related hemotoxicities is a challenging clinical problem, especially because the definition of the culprit pathological mechanism can be very complicated. In fact, some confounders, such as the baseline disease or concomitant therapies, as well as the direct effect on hematopoiesis of biologicals, all contribute to the growing difficulty in understanding the mechanism of hematotoxicity. This review summarizes the knowledge about the immune-mediated mechanisms of anemia, leucopenia, and thrombocytopenia associated with the use of biologicals.