Contributions
Abstract: PB1797
Type: Publication Only
Background
Constitutive activation of B-cell receptor signalling appears to be essential for the proliferation of malignant B cells. Bruton’s tyrosine kinase (BTK) has been identified as an essential component of the B-cell receptor signalling pathway. Ibrutinib is an orally administered BTK inhibitor that antagonises B cell receptor, chemokine & integrin mediated signalling.
Aims
We report our experience of using ibrutinib to treat relapsed/refractory B-cell chronic lymphocytic leukaemia (B-CLL) and mantle cell lymphoma (MCL) in a busy U.K. District General Hospital (DGH) serving a population of 600,000
Methods
26 patients were commenced on ibrutinib for relapsed/refractory B-CLL or MCL between August 2014 & December 2016. 16 patients had B-CLL and 10 patients had MCL. Patients with B-CLL were commenced on 420mg daily; those with MCL received 540mg daily. The median age at which ibrutinib was commenced was 71.1 years (range 50-85). The median age of patients with B-CLL was 71.1 years (range 50-80) and for MCL was 71.6 years (range 54-85).
Results
The median follow up was 15.5 months for B-CLL patients and 8 months for MCL patients. The median survival of all patients who did not receive anti-viral and pneumocystis prophylaxis was 5 months and the median survival for those who did receive prophylaxis was not reached (p <0.0001). The median survival of patients in both groups who had received more than 1 prior line of treatment was 17 months; the median survival in those who had received just one prior line of treatment was not reached (p= 0.0085). In the B-CLL cohort there was no difference in survival between those with and without 17p / p53 deletion.
Conclusion
Though our cohort of patients is small, our experience shows that the use of prophylaxis with co-trimoxazole and aciclovir is associated with significantly improved overall survival. Moreover, patients who received fewer lines of prior treatment had a better survival. Patients with 17p/p53 deleted B-CLL responded as well as those without a deletion. Ibrutinib is a very effective therapeutic option in patients with relapsed CLL and MCL.
Session topic: 6. Chronic lymphocytic leukemia and related disorders - Clinical
Keyword(s): Mantle cell lymphoma, B cell chronic lymphocytic leukemia
Abstract: PB1797
Type: Publication Only
Background
Constitutive activation of B-cell receptor signalling appears to be essential for the proliferation of malignant B cells. Bruton’s tyrosine kinase (BTK) has been identified as an essential component of the B-cell receptor signalling pathway. Ibrutinib is an orally administered BTK inhibitor that antagonises B cell receptor, chemokine & integrin mediated signalling.
Aims
We report our experience of using ibrutinib to treat relapsed/refractory B-cell chronic lymphocytic leukaemia (B-CLL) and mantle cell lymphoma (MCL) in a busy U.K. District General Hospital (DGH) serving a population of 600,000
Methods
26 patients were commenced on ibrutinib for relapsed/refractory B-CLL or MCL between August 2014 & December 2016. 16 patients had B-CLL and 10 patients had MCL. Patients with B-CLL were commenced on 420mg daily; those with MCL received 540mg daily. The median age at which ibrutinib was commenced was 71.1 years (range 50-85). The median age of patients with B-CLL was 71.1 years (range 50-80) and for MCL was 71.6 years (range 54-85).
Results
The median follow up was 15.5 months for B-CLL patients and 8 months for MCL patients. The median survival of all patients who did not receive anti-viral and pneumocystis prophylaxis was 5 months and the median survival for those who did receive prophylaxis was not reached (p <0.0001). The median survival of patients in both groups who had received more than 1 prior line of treatment was 17 months; the median survival in those who had received just one prior line of treatment was not reached (p= 0.0085). In the B-CLL cohort there was no difference in survival between those with and without 17p / p53 deletion.
Conclusion
Though our cohort of patients is small, our experience shows that the use of prophylaxis with co-trimoxazole and aciclovir is associated with significantly improved overall survival. Moreover, patients who received fewer lines of prior treatment had a better survival. Patients with 17p/p53 deleted B-CLL responded as well as those without a deletion. Ibrutinib is a very effective therapeutic option in patients with relapsed CLL and MCL.
Session topic: 6. Chronic lymphocytic leukemia and related disorders - Clinical
Keyword(s): Mantle cell lymphoma, B cell chronic lymphocytic leukemia