Ibrutinib as first line therapy in chronic lymphocytic leukemia patients over 80 years old: A retrospective real-life multicenter Italian cohort.
chronic lymphocytic leukemia
elderly
ibrutinib
therapy
Journal
Hematological oncology
ISSN: 1099-1069
Titre abrégé: Hematol Oncol
Pays: England
ID NLM: 8307268
Informations de publication
Date de publication:
Jan 2024
Jan 2024
Historique:
revised:
28
12
2023
received:
15
11
2023
accepted:
31
12
2023
medline:
30
1
2024
pubmed:
30
1
2024
entrez:
30
1
2024
Statut:
ppublish
Résumé
Although chronic lymphocytic leukemia (CLL) predominantly affects the elderly, limited data exists about the outcomes of over 80-year-old patients, usually underrepresented in clinical trials. We conducted a multicenter study enrolling 79 consecutive CLL patients ≥80 years at the time of frontline therapy, all treated with ibrutinib. Nearly 48% of cases exhibited unmutated IGHV genes, 32% 17p deletion, and 39.2% TP53 mutations; 63.3% displayed a cumulative illness rating scale (CIRS) > 6. The overall response rate on ibrutinib, computed in 74/79 patients (5 patients excluded for early withdrawal), was 89.9%. After a median follow-up of 28.9 months, the median progression-free survival (PFS) and overall survival (OS) were 42.5 and 51.8 months, respectively. CIRS>6 and temporary discontinuation of ibrutinib lasting for 7-30 days were the only parameters associated with a significantly shorter PFS and were both relevant in predicting a shorter PFS compared to patients with CIRS≤6 and therapy discontinuation ≤7 days. The most common grade≥3 adverse events were infections (25.5%), neutropenia (10.1%), and anemia (2.5%). Eighteen patients (22.8%) experienced a cardiovascular event, including grade-2 atrial fibrillation (n = 9; 11%), grade-2 hypertension (n = 5; 6%), heart failure (n = 3; 3%), and acute coronary syndrome (n = 1; 1%). Mild bleeding events were observed in 27 patients (34.2%). Ibrutinib was permanently discontinued in 26 patients due to progressive disease (n = 11, including 5 Richter's syndromes), secondary malignancies (n = 6), infections (n = 3), cardiac failure (n = 3), severe bleeding (n = 2), and sudden death (n = 1). In conclusion, our analyses confirmed the overall effectiveness and favorable safety profile of the ibrutinib-single agent therapeutic approach in CLL patients ≥80 years.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e3249Subventions
Organisme : Associazione Italiana Ricerca Cancro
ID : IG-21687
Organisme : Associazione Italiana contro le Leucemie, linfomi e mielomi, Venezia Section, Italy
Organisme : Progetto Ricerca Finalizzata PNRR-MAD-2022-12375673
ID : M6/C2_CALL 2022
Organisme : Italian Ministry of Health, Rome, Italy
Informations de copyright
© 2024 The Authors. Hematological Oncology published by John Wiley & Sons Ltd.
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