Redefining Chronic Lymphocytic Leukemia Response in the Ibrutinib Era

Persistent lymphocytosis is common after many months of therapy but does not portend a poorer outcome.

Ibrutinib is an oral inhibitor of the Bruton tyrosine kinase (BTK), a critical signaling molecule in the B-cell receptor (BCR) pathway that is activated in most B-cell malignancies, including chronic lymphocytic leukemia (CLL). Transient lymphocytosis, often marked, is almost always observed at treatment initiation due to rapid egress of CLL cells from lymph nodes and spleen that is persistent in about 20% of patients.

To understand the mechanisms of prolonged lymphocytosis and its effect on treatment outcome, investigators analyzed BCR signaling and biomarkers of the residual circulating CLL cells as compared with pretreatment cells. Patients with lymphocytosis after 6 to 12 months of continuous ibrutinib therapy were chosen for study.

Despi…

Reviewing Author

Michael E. Williams, MD, ScM

Disclosures

Consultant/Advisory BoardAbbVie; AstraZeneca; Beigene; Janssen; Pharmacyclics

Grant/Research SupportJanssen

Editorial BoardsAmerican Board of Internal Medicine (ABIM) Hematology Longitudinal Knowledge Approval Committee

Michael E. Williams, MD, ScM

Disclosures

Consultant/Advisory BoardAbbVie; AstraZeneca; Beigene; Janssen; Pharmacyclics

Grant/Research SupportJanssen

Editorial BoardsAmerican Board of Internal Medicine (ABIM) Hematology Longitudinal Knowledge Approval Committee

Redefining Chronic Lymphocytic Leukemia Response in the Ibrutinib Era

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Reviewing Author