학술논문

Evaluation of 230 patients with relapsed/refractory deletion 17p chronic lymphocytic leukaemia treated with ibrutinib from 3 clinical trials
Document Type
article
Source
British Journal of Haematology. 182(4)
Subject
Biomedical and Clinical Sciences
Cardiovascular Medicine and Haematology
Oncology and Carcinogenesis
Cancer
Hematology
Lymphoma
Clinical Research
Rare Diseases
Adenine
Adult
Aftercare
Aged
Aged
80 and over
Chromosome Deletion
Chromosomes
Human
Pair 17
Disease-Free Survival
Female
Humans
Leukemia
Lymphocytic
Chronic
B-Cell
Male
Middle Aged
Piperidines
Pyrazoles
Pyrimidines
Recurrence
Smith-Magenis Syndrome
Survival Rate
17p deletion
BTK inhibitor
chronic lymphocytic leukaemia
ibrutinib
Cardiorespiratory Medicine and Haematology
Immunology
Cardiovascular medicine and haematology
Language
Abstract
Patients with chronic lymphocytic leukaemia/small lymphocytic lymphoma (CLL/SLL) with deletion 17p [del(17p)] have poor outcomes with chemoimmunotherapy. Ibrutinib is indicated for the treatment of CLL/SLL, including del(17p) CLL/SLL, and allows for treatment without chemotherapy. This integrated analysis was performed to evaluate outcomes in 230 patients with relapsed/refractory del(17p) CLL/SLL from three ibrutinib studies. With a median of 2 prior therapies (range, 1-12), 18% and 79% of evaluable patients had del(11q) or unmutated IGHV, respectively. With a median follow-up of 28 months, overall response rate was 85% and estimated 30-month progression-free and overall survival rates were 57% [95% confidence interval (CI) 50-64] and 69% (95% CI 61-75), respectively. Patients with normal lactate dehydrogenase or no bulky disease had the most favourable survival outcomes. Sustained haematological improvements in haemoglobin, platelet count and absolute neutrophil count occurred in 61%, 67% and 70% of patients with baseline cytopenias, respectively. New onset severe cytopenias and infections decreased in frequency over time. Progression-free and overall survival with ibrutinib surpass those of other therapies for patients with del(17p) CLL/SLL. These results provide further evidence of the robust clinical activity of ibrutinib in difficult-to-treat CLL/SLL populations.