Outcomes of patients with chronic lymphocytic leukemia after discontinuing ibrutinib

P Jain, M Keating, W Wierda, Z Estrov… - Blood, The Journal …, 2015 - ashpublications.org
P Jain, M Keating, W Wierda, Z Estrov, A Ferrajoli, N Jain, B George, D James, H Kantarjian…
Blood, The Journal of the American Society of Hematology, 2015ashpublications.org
Ibrutinib is a Bruton tyrosine kinase inhibitor approved for the treatment of patients with
relapsed refractory chronic lymphocytic leukemia (RR-CLL). We describe the characteristics,
causes of discontinuation, and outcomes in patients who discontinued treatment with
ibrutinib. One hundred twenty-seven patients were enrolled in various clinical trials of
ibrutinib, with or without rituximab, at our center. Thirty-three (26%) patients have
discontinued ibrutinib to date. The majority of those patients had high-risk features: 94% with …
Abstract
Ibrutinib is a Bruton tyrosine kinase inhibitor approved for the treatment of patients with relapsed refractory chronic lymphocytic leukemia (RR-CLL). We describe the characteristics, causes of discontinuation, and outcomes in patients who discontinued treatment with ibrutinib. One hundred twenty-seven patients were enrolled in various clinical trials of ibrutinib, with or without rituximab, at our center. Thirty-three (26%) patients have discontinued ibrutinib to date. The majority of those patients had high-risk features: 94% with unmutated immunoglobulin heavy chain variable gene rearrangement, 58% with del(17p) by fluorescence in situ hybridization, and 54% with a complex karyotype. Causes of discontinuation were disease transformation (7), progressive CLL (7), stem cell transplantation (3), adverse events (11), serious adverse events/deaths (3), and miscellaneous reasons (2). Twenty five patients (76%) died after discontinuing ibrutinib; the median overall survival was 3.1 months after discontinuation. Most patients with RR-CLL who discontinued ibrutinib early were difficult to treat and had poor outcomes.
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