학술논문
Ibrutinib in combination with rituximab is highly effective in treatment of chronic lymphocytic leukemia patients with steroid refractory and relapsed autoimmune cytopenias
Document Type
Article
Author
Nikitin, Eugene; Kislova, Maria; Morozov, Dmitry; Belyakova, Vera; Suvorova, Anna; Sveshnikova, Julia; Vyscub, Galina; Matveeva, Irina; Shirokova, Maria; Shipaeva, Anna; Klitochenko, Tatyana; Makarovskaya, Polina; Dmitrieva, Elena; Biderman, Bella; Sudarikov, Andrei; Obukhova, Tatyana; Samoilova, Olga; Kaplanov, Kamil; Konstantinova, Tatyana; Mayorova, Olga; Poddubnaya, Irina; Ptushkin, Vadim
Source
Leukemia; July 2023, Vol. 37 Issue: 7 p1464-1473, 10p
Subject
Language
ISSN
08876924; 14765551
Abstract
Autoimmune hemolytic anemia (AIHA) and pure red cell aplasia (PRCA) are common complications of CLL. The optimal treatment of steroid refractory AIHA/PRCA is not well established. We conducted a multicenter study of ibrutinib and rituximab in patients with relapsed/refractory to steroids AIHA/PRCA and underlying CLL. Protocol included induction (ibrutinib 420 mg/day and rituximab, 8 weekly and 4 monthly infusions) and maintenance phase with ibrutinib alone until progression or unacceptable toxicity. Fifty patients were recruited (44—warm AIHA, 2—cold AIHA, 4—PRCA). After the induction 34 patients (74%) have achieved complete response, 10 (21.7%) partial response. Median time to hemoglobin normalization was 85 days. With regards to CLL response 9 (19%) patients have achieved CR, 2 (4%) patients—stabilization and 39 (78%)—PR. The median follow-up was 37.56 months. In AIHA group 2 patients had a relapse. Among 4 patients with PRCA 1 patient did not respond, and 1 patient had a relapse after CR, 2 remained in CR. The most common adverse events were neutropenia (62%), infections (72%), gastrointestinal complications (54%). In conclusion ibrutinib in combination with rituximab is an active second-line treatment option for patients with relapsed or refractory AIHA/PRCA and underlying CLL.