학술논문
Ibrutinib as a treatment of hematologic autoimmune disorders in patients with indolent B-cell lymphoma.
Document Type
Academic Journal
Author
Daniel A; Department of Hematology, Claude Huriez University Hospital, Lille, France.; Ghez D; Department of Hematology and INSERM UMR1030, Gustave Roussy, Villejuif, France.; Ravaiau C; Department of Internal Medicine, Angers University Hospital, Angers, France.; Cavalieri D; Department of Hematology, Estaing University Hospital, Clermont-Ferrand, France.; Tournilhac O; Department of Hematology, Estaing University Hospital, Clermont-Ferrand, France.; Herbaux C; Department of Hematology, St Eloi University Hospital, Montpellier, France.; Roriz M; Department of Internal Medicine, Agen-Nérac Hospital, Agen, France.; Wemeau M; Department of Hematology, Victor Provo Hospital, Roubaix, France.; Guillet S; Department of Internal Medicine, Henri-Mondor University Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France.; Bossard JB; Department of Hematology, Lens Hospital, Lens, France.; Hélène D; Department of Hematology, Dunkerque Hospital, Dunkerque, France.; Kaphan E; Department of Hematology, Grenoble-Alpes University Hospital, Grenoble, France.; Caroline R; Department of Hematology, Pierre Oudot Hospital, Bourgoin-Jallieu, France.; Florence L; Department of Hematology, Pierre Oudot Hospital, Bourgoin-Jallieu, France.; Pierache A; Univ.Lille, CHU Lille, ULR 2694-METRICS: évaluation des technologies de santé et des pratiques médicales, Lille, France.; Michel M; Department of Internal Medicine, Henri-Mondor University Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France.; Godeau B; Department of Internal Medicine, Henri-Mondor University Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France.; Terriou L; Department of Internal Medicine and Clinical Immunology, University of Lille, Lille, France.
Source
Publisher: Blackwell Country of Publication: England NLM ID: 8703985 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1600-0609 (Electronic) Linking ISSN: 09024441 NLM ISO Abbreviation: Eur J Haematol Subsets: MEDLINE
Subject
Language
English
Abstract
Background: Autoimmune conditions in B-cell lymphomas are frequent. Steroids are standard of care, but many patients require other immunosuppressive agents. Ibrutinib is a Bruton Tyrosine Kinase inhibitor that is approved for B-cell indolent lymphoma treatment. We evaluated the use of ibrutinib in previously treated hematologic immune manifestations associated with B-cell lymphomas.
Results: We conducted a retrospective multicentric observational study. Patients presenting with active, relapsed/refractory B-cell lymphoma associated hematological immune manifestation (autoimmune cytopenia, acquired immune-mediated bleeding disorders) were included. Twenty-five patients were identified. Median age at ibrutinib introduction was 69 years (range 44-84) and median number of previous treatment lines before ibrutinib was 2 (1-7). Twenty-two patients (88%) were on concomitant stable treatment at inclusion. Within a median exposure of 8 months (2-35), overall response rate to ibrutinib on immune manifestations was 76% (95% CI, 54.9-90.6); complete response rate 44%. Fourteen patients (63%) were able to be weaned from concomitant treatments. Fourteen patients (56%) presented treatment-related adverse events, mostly Grade 1 or 2.
Conclusions: Ibrutinib in this setting provides good efficacy and safety profile. Clinical trials are needed to define subgroups of patients who will benefit from this strategy and establish its place in the therapeutic arsenal.
(© 2022 The Authors. European Journal of Haematology published by John Wiley & Sons Ltd.)
Results: We conducted a retrospective multicentric observational study. Patients presenting with active, relapsed/refractory B-cell lymphoma associated hematological immune manifestation (autoimmune cytopenia, acquired immune-mediated bleeding disorders) were included. Twenty-five patients were identified. Median age at ibrutinib introduction was 69 years (range 44-84) and median number of previous treatment lines before ibrutinib was 2 (1-7). Twenty-two patients (88%) were on concomitant stable treatment at inclusion. Within a median exposure of 8 months (2-35), overall response rate to ibrutinib on immune manifestations was 76% (95% CI, 54.9-90.6); complete response rate 44%. Fourteen patients (63%) were able to be weaned from concomitant treatments. Fourteen patients (56%) presented treatment-related adverse events, mostly Grade 1 or 2.
Conclusions: Ibrutinib in this setting provides good efficacy and safety profile. Clinical trials are needed to define subgroups of patients who will benefit from this strategy and establish its place in the therapeutic arsenal.
(© 2022 The Authors. European Journal of Haematology published by John Wiley & Sons Ltd.)