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

Paul J. Hampel, Wei Ding, Timothy G. Call, Kari G. Rabe, Saad S. Kenderian, Thomas E. 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 E. Kay, Sameer A. Parikh

Research output: Contribution to journalArticlepeer-review

8 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)
Pages (from-to)2712-2719
Number of pages8
JournalLeukemia and Lymphoma
Volume60
Issue number11
DOIs
StatePublished - Sep 19 2019

Keywords

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

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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