Outcomes of Patients With Chronic Lymphocytic Leukemia Treated With Bruton Tyrosine Kinase Inhibitors (BTKi): A Retrospective Study From a Tertiary Healthcare Center in North India

Background and objectives: Bruton tyrosine kinase inhibitors (BTKi) are a pivotal advancement in treating chronic lymphocytic leukemia (CLL).However, their adoption faces challenges such as high discontinuation rates caused by adverse events like cardiac and hematologic toxicities and a significant financial burden.Our study aims to evaluate the clinical spectrum and outcomes of patients with CLL receiving BTKi therapy in India.The objectives are to evaluate progression-free survival and overall survival in CLL patients on BTKi and to assess the BTKi toxicity profile.Materials and methods: This retrospective, single-center study analyzed data from 41 patients with CLL treated with BTKi between January 2019 and November 2024.Results: Twenty-five male patients and 16 female patients were evaluated, with a median age of 64 years (range 42-90).Twelve patients (29.2%) had no cytogenetic abnormalities, while 29 (70.7%) had at least one abnormality; 13q deletion was the most common.BTKi was used as first-line therapy in 29 patients (70.7%), with acalabrutinib being the most commonly used agent, administered to 17 (58.6%)patients.Cardiac events were observed in 8 (19.5%) patients, including hypertension in four (9.7%) and atrial fibrillation in two (4.9%).Gastrointestinal adverse events were noted in 7 (17%) patients.One patient had Richter transformation to diffuse large B-cell lymphoma.At a median follow-up of 24 months, progression-free survival was 80% and overall survival was 95%.Conclusions: BTKi therapy is effective and well tolerated in Indian CLL patients, but early discontinuation highlights the need for improved adherence strategies.