Contributions
Abstract: PB1877
Type: Publication Only
Background
Background: atrial fibrillation (AF) is a frequent comorbidity in patients with chronic lymphocytic leukemia (CLL) receiving treatment with ibrutinib (Ib).
Aims
Aim: to study the incidence of AF and the possibility of using various anticoagulants in patients with CLL in the background of treatment with Ib.
Methods
Methods: We examined 174 patients with CLL who received Ib 420 mg as the first, second, third and fourth lines of therapy. All patients underwent electrocardiography, echocardiography and 24-hour ECG monitoring.
Results
Results: The study included patients aged 32 to 95 years (66.0 (59.0-72.0) years), 111 men aged 32 to 95 years (66.0 (60.0 - 72, 0) years) and 63 women aged 39 to 83 years (64.0 (54.0 -71.0) years), p = 0.34. AF was detected in 25 patients (14.7%) receiving Ib. In 11 patients (6.4%) AF diagnosed before the onset of treatment with Ib. In 14 patients (8.2%) AF occurred during the treatment with Ib in the period from 1 to 24 months (4.5 (2.0 - 16.0) months). 6 patients with AF (24%) had a permanent form, 19 had paroxysmal AF (76%). In 2 patients the paroxysmal form changed to a constant one during the Ib treatment period.
In accordance with the recommendations of the ESC on diagnosis and treatment of AF in 2016 and the scale CHA2DS2-VASc, anticoagulants received 14 patients (56%), of whom 3 patients received dabigatran etexilate (dabi) at a dose of 150 mg * 2 times a day, 7 patients received rivaroxaban (riva) at a dose of 20 mg per day, 4 patients was treated apixaban (api) at a dose of 5 mg * 2 times a day. In 3 patients (12%) receiving anticoagulants occurred non-major bleeding: in one patient taking riva 20 mg / day there was hematuria during occurred thrombocytopenia and anticoagulant treatment was canceled; one patient receiving dabi 150 * 2 times a day had repeated nasal bleeding (to him was prescribed api at a dose of 2.5 mg * 2 times a day); in one patient treating with api 5 mg * 2 times a day there was a hematoma with a small external bleeding (the dose was reduced to 2.5 mg * 2 times a day). Riva was abolished in 3 patients (12%) because of severe thrombocytopenia.
Conclusion
Conclusion: careful monitoring of patients with CLL and AF receiving treatment with Ib and anticoagulant therapy is necessary to early detect thrombocytopenia, hemorrhagic complications and timely dose adjustment or anticoagulant withdrawal.
Session topic: 6. Chronic lymphocytic leukemia and related disorders - Clinical
Keyword(s): Arterial Thrombosis, Lymphoma therapy, Patient, Tyrosine kinase inhibitor
Abstract: PB1877
Type: Publication Only
Background
Background: atrial fibrillation (AF) is a frequent comorbidity in patients with chronic lymphocytic leukemia (CLL) receiving treatment with ibrutinib (Ib).
Aims
Aim: to study the incidence of AF and the possibility of using various anticoagulants in patients with CLL in the background of treatment with Ib.
Methods
Methods: We examined 174 patients with CLL who received Ib 420 mg as the first, second, third and fourth lines of therapy. All patients underwent electrocardiography, echocardiography and 24-hour ECG monitoring.
Results
Results: The study included patients aged 32 to 95 years (66.0 (59.0-72.0) years), 111 men aged 32 to 95 years (66.0 (60.0 - 72, 0) years) and 63 women aged 39 to 83 years (64.0 (54.0 -71.0) years), p = 0.34. AF was detected in 25 patients (14.7%) receiving Ib. In 11 patients (6.4%) AF diagnosed before the onset of treatment with Ib. In 14 patients (8.2%) AF occurred during the treatment with Ib in the period from 1 to 24 months (4.5 (2.0 - 16.0) months). 6 patients with AF (24%) had a permanent form, 19 had paroxysmal AF (76%). In 2 patients the paroxysmal form changed to a constant one during the Ib treatment period.
In accordance with the recommendations of the ESC on diagnosis and treatment of AF in 2016 and the scale CHA2DS2-VASc, anticoagulants received 14 patients (56%), of whom 3 patients received dabigatran etexilate (dabi) at a dose of 150 mg * 2 times a day, 7 patients received rivaroxaban (riva) at a dose of 20 mg per day, 4 patients was treated apixaban (api) at a dose of 5 mg * 2 times a day. In 3 patients (12%) receiving anticoagulants occurred non-major bleeding: in one patient taking riva 20 mg / day there was hematuria during occurred thrombocytopenia and anticoagulant treatment was canceled; one patient receiving dabi 150 * 2 times a day had repeated nasal bleeding (to him was prescribed api at a dose of 2.5 mg * 2 times a day); in one patient treating with api 5 mg * 2 times a day there was a hematoma with a small external bleeding (the dose was reduced to 2.5 mg * 2 times a day). Riva was abolished in 3 patients (12%) because of severe thrombocytopenia.
Conclusion
Conclusion: careful monitoring of patients with CLL and AF receiving treatment with Ib and anticoagulant therapy is necessary to early detect thrombocytopenia, hemorrhagic complications and timely dose adjustment or anticoagulant withdrawal.
Session topic: 6. Chronic lymphocytic leukemia and related disorders - Clinical
Keyword(s): Arterial Thrombosis, Lymphoma therapy, Patient, Tyrosine kinase inhibitor