Originally Posted by Zent & Kay 2010
Autoimmune cytopenia complicating CLL is usually caused by polyclonal T cell dependent mechanisms that result from the loss of self tolerance. The pathogenic antibodies responsible for about 90% of cases of AIHA and ITP are produced by non-malignant B cells and are polyclonal high affinity IgG directed against red blood cell (RBC) or platelet antigens. These antibodies can ligate antigens on RBC and platelets and the opsonized cells are then destroyed via an antibody dependent cellular cytotoxicity (ADCC) mechanism mediated predominantly by fixed macrophages in the spleen and liver.
makes it sound like the malignant CLL cells are acting as dysregulated antigen-presenting cells...