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Updated: Apr 18, 2026
Immunoglobulin Gene Sequence Analysis In Chronic Lymphocytic Leukemia: From Patient Material To Sequence Interpretation
Published on: November 26, 2018
Outcomes of patients with chronic lymphocytic leukemia after discontinuing ibrutinib
Preetesh Jain1, Michael Keating2, William Wierda2
1Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX; Department of Internal Medicine, University of Texas Medical School at Houston, Houston, TX; and.
Insights
Discontinuing ibrutinib early in relapsed refractory chronic lymphocytic leukemia (RR-CLL) is linked to poor outcomes. Most patients who stopped treatment due to disease progression or adverse events had high-risk features and died within months.
Area of Science:
- Oncology
- Hematology
- Pharmacology
Background:
- Ibrutinib is a targeted therapy for relapsed refractory chronic lymphocytic leukemia (RR-CLL).
- Understanding reasons for treatment discontinuation and subsequent outcomes is crucial for managing high-risk CLL patients.
Purpose of the Study:
- To characterize patients with RR-CLL who discontinued ibrutinib treatment.
- To identify causes of ibrutinib discontinuation and analyze patient outcomes post-discontinuation.
Main Methods:
- Retrospective analysis of 127 patients with RR-CLL treated with ibrutinib in clinical trials.
- Data collection on patient characteristics, reasons for discontinuation, and survival post-discontinuation.
Main Results:
- 26% of patients discontinued ibrutinib. Most had high-risk features (unmutated IGHV, del(17p), complex karyotype).
- Common discontinuation reasons included adverse events (11), progressive CLL (7), and disease transformation (7).
- 76% of patients died after discontinuation, with a median overall survival of 3.1 months.
Conclusions:
- Early ibrutinib discontinuation in RR-CLL is associated with poor prognosis.
- Patients discontinuing ibrutinib often have aggressive disease and limited treatment options, leading to unfavorable outcomes.
Abstract:
Ibrutinib is a Bruton tyrosine kinase inhibitor approved for the treatment of patients with relapsed refractory chronic lymphocytic leukemia (RR-CLL). We describe the characteristics, causes of discontinuation, and outcomes in patients who discontinued treatment with ibrutinib. One hundred twenty-seven patients were enrolled in various clinical trials of ibrutinib, with or without rituximab, at our center. Thirty-three (26%) patients have discontinued ibrutinib to date. The majority of those patients had high-risk features: 94% with unmutated immunoglobulin heavy chain variable gene rearrangement, 58% with del(17p) by fluorescence in situ hybridization, and 54% with a complex karyotype. Causes of discontinuation were disease transformation (7), progressive CLL (7), stem cell transplantation (3), adverse events (11), serious adverse events/deaths (3), and miscellaneous reasons (2). Twenty five patients (76%) died after discontinuing ibrutinib; the median overall survival was 3.1 months after discontinuation. Most patients with RR-CLL who discontinued ibrutinib early were difficult to treat and had poor outcomes.
