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Nikitin E, Kislova M, Morozov D, Belyakova V, Suvorova A, Sveshnikova J, Vyscub G, Matveeva I, Shirokova M, Shipaeva A, Klitochenko T, Makarovskaya P, Dmitrieva E, Biderman B, Sudarikov A, Obukhova T, Samoilova O, Kaplanov K, Konstantinova T, Mayorova O, Poddubnaya I, Ptushkin V. Ibrutinib in combination with rituximab is highly effective in treatment of chronic lymphocytic leukemia patients with steroid refractory and relapsed autoimmune cytopenias. Leukemia 2023:10.1038/s41375-023-01891-3. [PMID: 37202442 DOI: 10.1038/s41375-023-01891-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 03/08/2023] [Accepted: 03/30/2023] [Indexed: 05/20/2023]
Abstract
Autoimmune hemolytic anemia (AIHA) and pure red cell aplasia (PRCA) are common complications of CLL. The optimal treatment of steroid refractory AIHA/PRCA is not well established. We conducted a multicenter study of ibrutinib and rituximab in patients with relapsed/refractory to steroids AIHA/PRCA and underlying CLL. Protocol included induction (ibrutinib 420 mg/day and rituximab, 8 weekly and 4 monthly infusions) and maintenance phase with ibrutinib alone until progression or unacceptable toxicity. Fifty patients were recruited (44-warm AIHA, 2-cold AIHA, 4-PRCA). After the induction 34 patients (74%) have achieved complete response, 10 (21.7%) partial response. Median time to hemoglobin normalization was 85 days. With regards to CLL response 9 (19%) patients have achieved CR, 2 (4%) patients-stabilization and 39 (78%)-PR. The median follow-up was 37.56 months. In AIHA group 2 patients had a relapse. Among 4 patients with PRCA 1 patient did not respond, and 1 patient had a relapse after CR, 2 remained in CR. The most common adverse events were neutropenia (62%), infections (72%), gastrointestinal complications (54%). In conclusion ibrutinib in combination with rituximab is an active second-line treatment option for patients with relapsed or refractory AIHA/PRCA and underlying CLL.
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Affiliation(s)
- Eugene Nikitin
- State Budgetary Healthcare Institution of the city of Moscow City Clinical Hospital named after S.P. Botkin of Moscow City Healthcare Department, Moscow, Russian Federation.
- Federal State Budgetary Educational Institution of Further Professional Education "Russian Medical Academy of Continuous Professional Education" of the Ministry of Healthcare of the Russian Federation, Moscow, Russian Federation.
| | - Maria Kislova
- State Budgetary Healthcare Institution of the city of Moscow City Clinical Hospital named after S.P. Botkin of Moscow City Healthcare Department, Moscow, Russian Federation
| | - Dmitry Morozov
- State Budgetary Health Institution of the Nizhny Novgorod Region "Nizhny Novgorod Regional Clinical Hospital named after N.A. Semashko", Nizhny, Novgorod, Russian Federation
| | - Vera Belyakova
- State Budgetary Healthcare Institution of the city of Moscow Blood Center named after O.K. Gavrilov of the Moscow City Healthcare Department, Moscow, Russian Federation
| | - Anna Suvorova
- State Budgetary Health Institution of the Nizhny Novgorod Region "Nizhny Novgorod Regional Clinical Hospital named after N.A. Semashko", Nizhny, Novgorod, Russian Federation
| | - Julia Sveshnikova
- State Autonomous Healthcare Institution of the Sverdlovsk Region "Sverdlovsk Regional Clinical Hospital N 1", Ekaterinburg, Russian Federation
| | - Galina Vyscub
- State Budgetary Health Institution "Volgograd Regional Clinical Oncology Center", Volgograd, Russian Federation
| | - Irina Matveeva
- State Budgetary Health Institution "Volgograd Regional Clinical Oncology Center", Volgograd, Russian Federation
| | - Maria Shirokova
- State Budgetary Healthcare Institution of the city of Moscow City Clinical Hospital named after S.P. Botkin of Moscow City Healthcare Department, Moscow, Russian Federation
| | - Anna Shipaeva
- State Budgetary Health Institution "Volgograd Regional Clinical Oncology Center", Volgograd, Russian Federation
| | - Tatyana Klitochenko
- State Budgetary Health Institution "Volgograd Regional Clinical Oncology Center", Volgograd, Russian Federation
| | - Polina Makarovskaya
- State Budgetary Health Institution of the Nizhny Novgorod Region "Nizhny Novgorod Regional Clinical Hospital named after N.A. Semashko", Nizhny, Novgorod, Russian Federation
| | - Elena Dmitrieva
- State Budgetary Healthcare Institution of the city of Moscow City Clinical Hospital named after S.P. Botkin of Moscow City Healthcare Department, Moscow, Russian Federation
| | - Bella Biderman
- National Medical Research Center for Hematology, Moscow, Russian Federation
| | - Andrei Sudarikov
- National Medical Research Center for Hematology, Moscow, Russian Federation
| | - Tatyana Obukhova
- National Medical Research Center for Hematology, Moscow, Russian Federation
| | - Olga Samoilova
- State Budgetary Health Institution of the Nizhny Novgorod Region "Nizhny Novgorod Regional Clinical Hospital named after N.A. Semashko", Nizhny, Novgorod, Russian Federation
| | - Kamil Kaplanov
- State Budgetary Healthcare Institution of the city of Moscow City Clinical Hospital named after S.P. Botkin of Moscow City Healthcare Department, Moscow, Russian Federation
| | - Tatyana Konstantinova
- State Autonomous Healthcare Institution of the Sverdlovsk Region "Sverdlovsk Regional Clinical Hospital N 1", Ekaterinburg, Russian Federation
| | - Olga Mayorova
- State Budgetary Healthcare Institution of the city of Moscow Blood Center named after O.K. Gavrilov of the Moscow City Healthcare Department, Moscow, Russian Federation
| | - Irina Poddubnaya
- Federal State Budgetary Educational Institution of Further Professional Education "Russian Medical Academy of Continuous Professional Education" of the Ministry of Healthcare of the Russian Federation, Moscow, Russian Federation
| | - Vadim Ptushkin
- State Budgetary Healthcare Institution of the city of Moscow City Clinical Hospital named after S.P. Botkin of Moscow City Healthcare Department, Moscow, Russian Federation
- Federal State Budgetary Educational Institution of Further Professional Education "Russian Medical Academy of Continuous Professional Education" of the Ministry of Healthcare of the Russian Federation, Moscow, Russian Federation
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Ionova T, Anchukova L, Dubov S, Esenina T, Ivanova L, Kaplanov K, Kochkareva Y, Kopylova A, Kravchuk T, Levanov A, Li O, Nikitina T, Rukavitsyn O, Saraeva N, Savinova M, Shelekhova T, Simashova P, Shirokova M, Vinogradova O, Volkova S. 902P Quality of life and response to treatment with ixazomib-lenalidomide-dexamethasone (IRd) in patients with relapsed/refractory multiple myeloma (RRMM) in a real-world setting. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Kaplanov K, Klitochenko T, Shipaeva A, Shirokova M, Matveeva I, Lavrishina N. Combination of idarubicin, vinblastine, dacarbazine, and gemcitabine (IVDG) as therapy for elderly patients with Hodgkin lymphoma with cardiac and pulmonary comorbidity. Hematol Oncol 2017. [DOI: 10.1002/hon.2439_57] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- K. Kaplanov
- Hematology; Volgograd Regional Clinical Oncology Dispensary, Volgograd Medical Research Cente; Volgograd Russian Federation
| | - T. Klitochenko
- Hematology; Volgograd Regional Clinical Oncology Dispensary; Volgograd Russian Federation
| | - A. Shipaeva
- Hematology; Volgograd Regional Clinical Oncology Dispensary; Volgograd Russian Federation
| | - M. Shirokova
- Hematology; Volgograd Regional Clinical Oncology Dispensary; Volgograd Russian Federation
| | - I. Matveeva
- Hematology; Volgograd Regional Clinical Oncology Dispensary; Volgograd Russian Federation
| | - N. Lavrishina
- Hematology; Volgograd Regional Clinical Oncology Dispensary; Volgograd Russian Federation
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