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. 2015 Mar 26;125(13):2062-7.
doi: 10.1182/blood-2014-09-603670. Epub 2015 Jan 8.

Outcomes of patients with chronic lymphocytic leukemia after discontinuing ibrutinib

Preetesh Jain  1 , Michael Keating  2 , William Wierda  2 , Zeev Estrov  2 , Alessandra Ferrajoli  2 , Nitin Jain  2 , Binsah George  2 , Danelle James  3 , Hagop Kantarjian  2 , Jan Burger  2 , Susan O'Brien  2
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Outcomes of patients with chronic lymphocytic leukemia after discontinuing ibrutinib

Preetesh Jain et al. Blood. .

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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Figures

Figure 1
Figure 1
Survival of patients after discontinuation of ibrutinib. Patients survived for a median of 3.1 months after discontinuation of ibrutinib (n = 33).
Figure 2
Figure 2
Postibrutinib survival of patients who progressed (without transformation; n = 7) vs those who transformed (n = 7). Median survival in patients who progressed (untransformed) was not reached vs 2.6 months in those who transformed (P = .44).
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