Rapid disease progression following discontinuation of ibrutinib in patients with chronic lymphocytic leukemia treated in routine clinical practice

Paul J. Hampel, Wei D Ding, Timothy G. Call, Kari G. Rabe, Saad Kenderian, Thomas Elmer Witzig, Eli Muchtar, Jose F. Leis, Asher A Chanan Khan, Amber B. Koehler, Amie L. Fonder, Susan M. Schwager, Susan L Slager, Tait D. Shanafelt, Neil Elliot Kay, Sameer A Parikh

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

We identified all patients with chronic lymphocytic leukemia at Mayo Clinic treated with ibrutinib outside the context of a clinical trial; timing and reasons for discontinuation were ascertained, as were symptoms, exam and radiographic findings, and laboratory changes following discontinuation. Of 202 patients who received ibrutinib, 52 discontinued therapy (estimated 1- and 2-year risk of discontinuation 18% and 28%, respectively). The most common reasons for discontinuation were toxicity (56%) and progression of disease (32%, including Richter’s transformation in 15%). Rapid progression of disease within 4 weeks after discontinuation was observed in 9/36 (25%) patients with adequate records for review, mostly in those stopping ibrutinib for disease progression (n = 8) rather than toxicity (n = 1). This was evident by sudden worsening of disease-related symptoms (n = 9), exam/radiographic changes (n = 7), and laboratory changes (n = 8). An estimated one in every three patients discontinued ibrutinib by 2 years, with 25% developing rapid disease progression afterwards.

Original languageEnglish (US)
JournalLeukemia and Lymphoma
DOIs
StatePublished - Jan 1 2019

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Keywords

  • Chronic lymphocytic leukemia (CLL)
  • discontinuation
  • ibrutinib
  • progression

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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