• Preetesh Jain, Michael Keating, William Wierda, Zeev Estrov, Alessandra Ferrajoli, Nitin Jain, Binsah George, Danelle James, Hagop Kantarjian, Jan Burger, and Susan O'Brien.
• Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX; Department of Internal Medicine, University of Texas Medical School at Houston, Houston, TX; and.
• Blood. 2015 Mar 26; 125 (13): 2062-7.

AbstractIbrutinib 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. © 2015 by The American Society of Hematology.

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