Optimising outcomes for patients with chronic lymphocytic leukaemia on ibrutinib therapy: European recommendations for clinical practice

被引:63
作者
Gribben, John G. [1 ]
Bosch, Francesc [2 ]
Cymbalista, Florence [3 ,4 ,5 ]
Geisler, Christian H. [6 ]
Ghia, Paolo [7 ,8 ]
Hillmen, Peter [9 ]
Moreno, Carol [10 ]
Stilgenbauer, Stephan [11 ]
机构
[1] Queen Mary Univ London, Barts Canc Inst, London, England
[2] Vall dHebron Univ Hosp, Dept Haematol, Barcelona, Spain
[3] INSERM, U978, Paris, France
[4] Univ Paris 13, Sorbonne Paris Cite, Labex Inflamex, Bobigny, France
[5] Hop Avicenne, AP HP, Bobigny, France
[6] Rigshosp, Dept Haematol, Copenhagen, Denmark
[7] IRCCS, San Raffaele Hosp, Strateg Res Programme CLL, Milan, Italy
[8] Univ Vita Salute San Raffaele, Milan, Italy
[9] Univ Leeds, St James Inst Oncol, Leeds, W Yorkshire, England
[10] Autonomous Univ Barcelona, Hosp Santa Creu St Pau, Dept Haematol, Barcelona, Spain
[11] Univ Ulm, Dept Internal Med 3, Ulm, Germany
关键词
ibrutinib; chronic lymphocytic leukaemia; anticoagulation; bleeding; European recommendations; ATRIAL-FIBRILLATION; AUTOIMMUNE CYTOPENIAS; 17P DELETION; MANAGEMENT; RISK; PCI-32765; ANTICOAGULANTS; PATHOGENESIS; GUIDELINES; SURVIVAL;
D O I
10.1111/bjh.15080
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Ibrutinib is indicated in Europe for the treatment of several B-cell malignancies, including chronic lymphocytic leukaemia (CLL). However, despite the high efficacy and favourable toxicity profile of ibrutinib, recent data suggest that it is not always administered optimally in clinical practice, with an increased tendency for dose reduction and a higher frequency of discontinuation. An expert panel of European haematologists was convened to identify practical issues pertinent to physicians involved in the therapeutic management of ibrutinib-treated CLL patients and here we outline the findings. Practical management recommendations are given for treating patients with ibrutinib and clinical considerations for the management of adverse events (AEs) that can be associated with ibrutinib treatment are addressed. This article highlights that patients should be monitored for treatment emergent adverse events, most of which are mild, transient and generally occur early in therapy and that, even with more challenging AEs, patients can often be maintained on therapy with minimal disruption through careful management. The necessity to use the correct ibrutinib dose, along with increased awareness, vigilance, mitigation and management of AEs, are all recommended to maximise outcomes for CLL patients treated with ibrutinib.
引用
收藏
页码:666 / 679
页数:14
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