Cargando…

Evaluation of 230 patients with relapsed/refractory deletion 17p chronic lymphocytic leukaemia treated with ibrutinib from 3 clinical trials

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 an...

Descripción completa

Detalles Bibliográficos
Autores principales: Jones, Jeffrey, Mato, Anthony, Coutre, Steven, Byrd, John C., Furman, Richard R., Hillmen, Peter, Osterborg, Anders, Tam, Constantine, Stilgenbauer, Stephan, Wierda, William G., Heerema, Nyla A., Eckert, Karl, Clow, Fong, Zhou, Cathy, Chu, Alvina D., James, Danelle F., O'Brien, Susan M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6120509/
https://www.ncbi.nlm.nih.gov/pubmed/29873072
http://dx.doi.org/10.1111/bjh.15421
_version_ 1783352285532782592
author Jones, Jeffrey
Mato, Anthony
Coutre, Steven
Byrd, John C.
Furman, Richard R.
Hillmen, Peter
Osterborg, Anders
Tam, Constantine
Stilgenbauer, Stephan
Wierda, William G.
Heerema, Nyla A.
Eckert, Karl
Clow, Fong
Zhou, Cathy
Chu, Alvina D.
James, Danelle F.
O'Brien, Susan M.
author_facet Jones, Jeffrey
Mato, Anthony
Coutre, Steven
Byrd, John C.
Furman, Richard R.
Hillmen, Peter
Osterborg, Anders
Tam, Constantine
Stilgenbauer, Stephan
Wierda, William G.
Heerema, Nyla A.
Eckert, Karl
Clow, Fong
Zhou, Cathy
Chu, Alvina D.
James, Danelle F.
O'Brien, Susan M.
author_sort Jones, Jeffrey
collection PubMed
description 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.
format Online
Article
Text
id pubmed-6120509
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher John Wiley and Sons Inc.
record_format MEDLINE/PubMed
spelling pubmed-61205092018-09-05 Evaluation of 230 patients with relapsed/refractory deletion 17p chronic lymphocytic leukaemia treated with ibrutinib from 3 clinical trials Jones, Jeffrey Mato, Anthony Coutre, Steven Byrd, John C. Furman, Richard R. Hillmen, Peter Osterborg, Anders Tam, Constantine Stilgenbauer, Stephan Wierda, William G. Heerema, Nyla A. Eckert, Karl Clow, Fong Zhou, Cathy Chu, Alvina D. James, Danelle F. O'Brien, Susan M. Br J Haematol Haematological Malignancy 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. John Wiley and Sons Inc. 2018-06-05 2018-08 /pmc/articles/PMC6120509/ /pubmed/29873072 http://dx.doi.org/10.1111/bjh.15421 Text en © 2018 The Authors. British Journal of Haematology published by John Wiley & Sons Ltd This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Haematological Malignancy
Jones, Jeffrey
Mato, Anthony
Coutre, Steven
Byrd, John C.
Furman, Richard R.
Hillmen, Peter
Osterborg, Anders
Tam, Constantine
Stilgenbauer, Stephan
Wierda, William G.
Heerema, Nyla A.
Eckert, Karl
Clow, Fong
Zhou, Cathy
Chu, Alvina D.
James, Danelle F.
O'Brien, Susan M.
Evaluation of 230 patients with relapsed/refractory deletion 17p chronic lymphocytic leukaemia treated with ibrutinib from 3 clinical trials
title Evaluation of 230 patients with relapsed/refractory deletion 17p chronic lymphocytic leukaemia treated with ibrutinib from 3 clinical trials
title_full Evaluation of 230 patients with relapsed/refractory deletion 17p chronic lymphocytic leukaemia treated with ibrutinib from 3 clinical trials
title_fullStr Evaluation of 230 patients with relapsed/refractory deletion 17p chronic lymphocytic leukaemia treated with ibrutinib from 3 clinical trials
title_full_unstemmed Evaluation of 230 patients with relapsed/refractory deletion 17p chronic lymphocytic leukaemia treated with ibrutinib from 3 clinical trials
title_short Evaluation of 230 patients with relapsed/refractory deletion 17p chronic lymphocytic leukaemia treated with ibrutinib from 3 clinical trials
title_sort evaluation of 230 patients with relapsed/refractory deletion 17p chronic lymphocytic leukaemia treated with ibrutinib from 3 clinical trials
topic Haematological Malignancy
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6120509/
https://www.ncbi.nlm.nih.gov/pubmed/29873072
http://dx.doi.org/10.1111/bjh.15421
work_keys_str_mv AT jonesjeffrey evaluationof230patientswithrelapsedrefractorydeletion17pchroniclymphocyticleukaemiatreatedwithibrutinibfrom3clinicaltrials
AT matoanthony evaluationof230patientswithrelapsedrefractorydeletion17pchroniclymphocyticleukaemiatreatedwithibrutinibfrom3clinicaltrials
AT coutresteven evaluationof230patientswithrelapsedrefractorydeletion17pchroniclymphocyticleukaemiatreatedwithibrutinibfrom3clinicaltrials
AT byrdjohnc evaluationof230patientswithrelapsedrefractorydeletion17pchroniclymphocyticleukaemiatreatedwithibrutinibfrom3clinicaltrials
AT furmanrichardr evaluationof230patientswithrelapsedrefractorydeletion17pchroniclymphocyticleukaemiatreatedwithibrutinibfrom3clinicaltrials
AT hillmenpeter evaluationof230patientswithrelapsedrefractorydeletion17pchroniclymphocyticleukaemiatreatedwithibrutinibfrom3clinicaltrials
AT osterborganders evaluationof230patientswithrelapsedrefractorydeletion17pchroniclymphocyticleukaemiatreatedwithibrutinibfrom3clinicaltrials
AT tamconstantine evaluationof230patientswithrelapsedrefractorydeletion17pchroniclymphocyticleukaemiatreatedwithibrutinibfrom3clinicaltrials
AT stilgenbauerstephan evaluationof230patientswithrelapsedrefractorydeletion17pchroniclymphocyticleukaemiatreatedwithibrutinibfrom3clinicaltrials
AT wierdawilliamg evaluationof230patientswithrelapsedrefractorydeletion17pchroniclymphocyticleukaemiatreatedwithibrutinibfrom3clinicaltrials
AT heeremanylaa evaluationof230patientswithrelapsedrefractorydeletion17pchroniclymphocyticleukaemiatreatedwithibrutinibfrom3clinicaltrials
AT eckertkarl evaluationof230patientswithrelapsedrefractorydeletion17pchroniclymphocyticleukaemiatreatedwithibrutinibfrom3clinicaltrials
AT clowfong evaluationof230patientswithrelapsedrefractorydeletion17pchroniclymphocyticleukaemiatreatedwithibrutinibfrom3clinicaltrials
AT zhoucathy evaluationof230patientswithrelapsedrefractorydeletion17pchroniclymphocyticleukaemiatreatedwithibrutinibfrom3clinicaltrials
AT chualvinad evaluationof230patientswithrelapsedrefractorydeletion17pchroniclymphocyticleukaemiatreatedwithibrutinibfrom3clinicaltrials
AT jamesdanellef evaluationof230patientswithrelapsedrefractorydeletion17pchroniclymphocyticleukaemiatreatedwithibrutinibfrom3clinicaltrials
AT obriensusanm evaluationof230patientswithrelapsedrefractorydeletion17pchroniclymphocyticleukaemiatreatedwithibrutinibfrom3clinicaltrials