Atrial fibrillation in CLL patients treated with ibrutinib. An international retrospective study
Atrial fibrillation in CLL patients treated with ibrutinib. An international retrospective study
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DOI：
10.1111/bjh.14324
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发表时间：
2016-11-01
影响因子：
6.5
通讯作者：
Cymbalista, Florence
中科院分区：
文献类型：
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作者：
Thompson, Philip A.;Levy, Vincent;Cymbalista, Florence
在接受伊布鲁替尼治疗的慢性淋巴细胞白血病(CLL)患者中，5-9%的患者会发生心房颤动(AF)；其临床后果和最佳治疗方案尚不清楚。我们对56例接受伊布鲁替尼治疗并发生房颤的慢性粒细胞白血病患者进行了回顾性研究。中位发病时间为38个月。尽管接受了治疗，35/56例(62%)的房颤仍持续存在。临床后果包括：3次严重心力衰竭(1次死亡)和1次中风；8名非血小板减少患者(14%)出现严重出血不良事件。总共有26/56例患者(46%)永久停用伊布鲁替尼。缺乏指导最佳管理的数据，迫切需要临床实践指南。
Atrial fibrillation (AF) occurs in 5-9% of patients treated with ibrutinib for chronic lymphocytic leukaemia (CLL); the clinical consequences and optimal management are unclear. We retrospectively studied 56 CLL patients who received ibrutinib and developed AF. Median time to onset was 38months. AF was persistent in 35/56 (62%) cases despite treatment. Clinical consequences included: three episodes of severe cardiac failure (one fatal) and one stroke; eight non-thrombocytopenic patients (14%) experienced severe bleeding adverse events. Altogether, ibrutinib was permanently discontinued in 26/56 cases (46%). Data to guide optimal management are lacking and clinical practice guidelines are urgently needed.