Autoimmune cytopenias in patients with chronic lymphocytic leukaemia treated with ibrutinib in routine clinical practice at an academic medical centre.
Autoimmune cytopenias in patients with chronic lymphocytic leukaemia treated with ibrutinib in routine clinical practice at an academic medical centre.
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DOI：
10.1111/bjh.15545
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发表时间：
2018-11
影响因子：
6.5
通讯作者：
Parikh SA
中科院分区：
文献类型：
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作者：
Hampel PJ;Larson MC;Kabat B;Call TG;Ding W;Kenderian SS;Bowen D;Boysen J;Schwager SM;Leis JF;Chanan-Khan AA;Muchtar E;Hanson CA;Slager SL;Kay NE;Chaffee KG;Shanafelt TD;Parikh SA
在常规临床治疗的慢性淋巴细胞白血病(CLL)患者中，伊布鲁替尼对自身免疫性细胞减少症(AIC)自然病史的影响需要进一步研究。使用Mayo临床CLL数据库，确定了在2013年11月至2017年1月期间在临床试验范围外使用ibrutinib治疗的193名CLL患者；对他们的医疗记录进行了全面审查，以了解过去的AIC病史和治疗出现的AIC的详细情况。我们确定了29/193(15%)在伊布鲁替尼开始治疗前有AIC病史的患者。在伊布鲁替尼开始时需要AIC治疗的12名患者中，8名(67%)能够停止或降低AIC治疗，在开始使用ibrutinib后，没有患者的AIC恶化。11例(6%)患者在伊布鲁替尼开始治疗后的中位时间59天(范围6-319天)后出现治疗紧急AIC，其中7例(%)能够继续使用伊布鲁替尼。在有AIC病史和无AIC病史的患者中，从伊布鲁替尼开始的总体和无事件生存率没有显著差异。治疗出现的AIC仅见于未突变的IGHV患者，并与较短的EFS相关。这些结果表明，新发AIC的治愈率较低，现有AIC患者的情况有所改善。
The effects of ibrutinib on the natural history of autoimmune cytopenias (AIC) among chronic lymphocytic leukaemia (CLL) patients treated in routine clinical practice require further investigation. Using the Mayo Clinical CLL Database, 193 CLL patients treated with ibrutinib between November 2013 and January 2017 outside the context of a clinical trial were identified; complete review of their medical records was performed for details of past history of AIC and treatment-emergent AIC. We identified 29/193 (15%) patients with history of AIC prior to ibrutinib start. Of 12 patients requiring AIC therapy at ibrutinib start, 8 (67%) were able to discontinue or de-escalate AIC treatment, and no patient had worsening of their AIC after initiating ibrutinib. Eleven (6%) patients developed treatment-emergent AIC after a median of 59 (range, 6–319) days following the initiation of ibrutinib, 7 of whom (64%) were able to continue ibrutinib. Overall and event-free survival from time of ibrutinib start were not significantly different between patients with history of AIC and those with no history of AIC. Treatment-emergent AIC were seen exclusively in patients with unmutated IGHV and were associated with a shorter EFS. These results suggest a low rate of treatment-emergent AIC and improvement in patients with existing AIC.
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影响因子：
2.6
作者：
Zent CS;Ding W;Reinalda MS;Schwager SM;Hoyer JD;Bowen DA;Jelinek DF;Tschumper RC;Call TG;Shanafelt TD;Kay NE;Slager SL
通讯作者：
Slager SL
影响因子：
6.5
作者：
Zent, Clive S.;Ding, Wei;Slager, Susan L.
通讯作者：
Slager, Susan L.
影响因子：
3.4
作者：
HAMBLIN, TJ;OSCIER, DG;YOUNG, BJ
通讯作者：
YOUNG, BJ
影响因子：
12.8
作者：
Kyasa, MJ;Parrish, RS;Zent, CS
通讯作者：
Zent, CS
影响因子：
--
作者：
Podhorecka, Monika;Goracy, Aneta;Hus, Marek
通讯作者：
Hus, Marek