Ibrutinib in combination with rituximab is highly effective in treatment of chronic lymphocytic leukemia patients with steroid refractory and relapsed autoimmune cytopenias

被引：4

作者：

Nikitin, Eugene ^{[1
,2
]}

Kislova, Maria ^{[1
]}

Morozov, Dmitry ^{[3
]}

Belyakova, Vera ^{[4
]}

Suvorova, Anna ^{[3
]}

Sveshnikova, Julia ^{[5
]}

Vyscub, Galina ^{[6
]}

Matveeva, Irina ^{[6
]}

Shirokova, Maria ^{[1
]}

Shipaeva, Anna ^{[6
]}

Klitochenko, Tatyana ^{[6
]}

Makarovskaya, Polina ^{[3
]}

Dmitrieva, Elena ^{[1
]}

Biderman, Bella ^{[7
]}

Sudarikov, Andrei ^{[7
]}

Obukhova, Tatyana ^{[7
]}

Samoilova, Olga ^{[3
]}

Kaplanov, Kamil ^{[1
]}

Konstantinova, Tatyana ^{[5
]}

Mayorova, Olga ^{[4
]}

Poddubnaya, Irina ^{[2
]}

Ptushkin, Vadim ^{[1
,2
]}

机构：

[1] Moscow City Clin Hosp, Sate Budgetary Healthcare Inst, Moscow City Healthcare Dept, Moscow, Russia

[2] Minist Healthcare Russian Federat, Fed State Budgetary Educ Inst Further Profess Educ, Moscow, Russia

[3] Nzhny Novgorod Reg Nizhny Novgorod Reg Clin Hosp, State Budgetary Hlth Inst, Nizhny, Novgorod, Russia

[4] City Moscow Blood Ctr, State Budgetary Healthcare Inst, Moscow City Healthcare Dept, Moscow, Russia

[5] Sverdlovsk Reg Sverdlovsk Reg Clin Hosp 1, State Autonomous Healthcare Inst, Ekaterinburg, Russia

[6] State Budgetary Hlth Inst Volgograd Reg Clin Oncol, Volgograd, Russia

[7] Natl Med Res Ctr Hematol, Moscow, Russia

来源：

LEUKEMIA | 2023年 / 37卷 / 07期

关键词：

RED-CELL APLASIA; HEMOLYTIC-ANEMIA; PREDNISONE THERAPY; CYCLOPHOSPHAMIDE; INHIBITOR; LYMPHOMA; FLUDARABINE; MANAGEMENT; PCI-32765; BTK;

D O I：

10.1038/s41375-023-01891-3

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

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.

引用

页码：1464 / 1473

页数：10

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