Ibrutinib therapy in patients with chronic lymphocytic leukemia resulted in a 24.5% incidence of new-onset atrial fibrillation and a 68% treatment discontinuation rate over a median 32 months.
Cohort (n=134)
What is the incidence of cardiovascular and bleeding events in patients with chronic lymphocytic leukemia treated with ibrutinib in a real-world setting?
Real-world ibrutinib therapy in chronic lymphocytic leukemia is associated with significant cardiovascular and bleeding toxicities leading to high discontinuation rates.
OBJECTIVE: Ibrutinib treatment is associated with cardiovascular side effects, in particular atrial fibrillation (AF) and hypertension, as well as increased risk of bleeding. Here, we aimed at describing the incidence of these events during long-term follow-up in patients with chronic lymphocytic leukemia treated outside clinical trials as well as identifying clinical factors predictive of developing AF. Additionally, other reasons for treatment withdrawal were analyzed. METHODS: The study was retrospective, data were collected from medical records. RESULTS: A total of 134 patients were identified. Median follow-up was 32 months (range 3-103) and median duration of ibrutinib treatment was 26 months (range 1-103). Of 110 patients with no prior history of AF, 24.5% were diagnosed during treatment. Newly diagnosed or worsening of pre-existing hypertension occurred in 15.7%. Sixty-six % of the patients experienced bleeding events, of which 7.5% grade 3-4. Treatment discontinuation and dose reduction occurred in 68% and 47% of the patients, respectively, mostly due to toxicity. CONCLUSIONS: The incidence of AF was high and at a median follow-up of 2.5 years, two-thirds of the patients discontinued treatment mostly due to bleeding and infections. Treatment-related toxicity of any grade should be regarded as a concern of prolonged ibrutinib therapy.
Andersson et al. (2023) conducted a cohort in Chronic lymphocytic leukemia (n=134). Ibrutinib was evaluated on Newly diagnosed atrial fibrillation in patients with no prior history. Ibrutinib therapy in patients with chronic lymphocytic leukemia resulted in a 24.5% incidence of new-onset atrial fibrillation and a 68% treatment discontinuation rate over a median 32 months.