TY - JOUR
T1 - Optimising outcomes for patients with chronic lymphocytic leukaemia on ibrutinib therapy
T2 - European recommendations for clinical practice
AU - Gribben, John G.
AU - Bosch, Francesc
AU - Cymbalista, Florence
AU - Geisler, Christian H.
AU - Ghia, Paolo
AU - Hillmen, Peter
AU - Moreno, Carol
AU - Stilgenbauer, Stephan
PY - 2018
Y1 - 2018
N2 - Ibrutinib is indicated in Europe for the treatment of several B-cell malignancies, including chronic lymphocytic leukaemia (CLL). However, despite the high efficacy and favourable toxicity profile of ibrutinib, recent data suggest that it is not always administered optimally in clinical practice, with an increased tendency for dose reduction and a higher frequency of discontinuation. An expert panel of European haematologists was convened to identify practical issues pertinent to physicians involved in the therapeutic management of ibrutinib-treated CLL patients and here we outline the findings. Practical management recommendations are given for treating patients with ibrutinib and clinical considerations for the management of adverse events (AEs) that can be associated with ibrutinib treatment are addressed. This article highlights that patients should be monitored for treatment emergent adverse events, most of which are mild, transient and generally occur early in therapy and that, even with more challenging AEs, patients can often be maintained on therapy with minimal disruption through careful management. The necessity to use the correct ibrutinib dose, along with increased awareness, vigilance, mitigation and management of AEs, are all recommended to maximise outcomes for CLL patients treated with ibrutinib.
AB - Ibrutinib is indicated in Europe for the treatment of several B-cell malignancies, including chronic lymphocytic leukaemia (CLL). However, despite the high efficacy and favourable toxicity profile of ibrutinib, recent data suggest that it is not always administered optimally in clinical practice, with an increased tendency for dose reduction and a higher frequency of discontinuation. An expert panel of European haematologists was convened to identify practical issues pertinent to physicians involved in the therapeutic management of ibrutinib-treated CLL patients and here we outline the findings. Practical management recommendations are given for treating patients with ibrutinib and clinical considerations for the management of adverse events (AEs) that can be associated with ibrutinib treatment are addressed. This article highlights that patients should be monitored for treatment emergent adverse events, most of which are mild, transient and generally occur early in therapy and that, even with more challenging AEs, patients can often be maintained on therapy with minimal disruption through careful management. The necessity to use the correct ibrutinib dose, along with increased awareness, vigilance, mitigation and management of AEs, are all recommended to maximise outcomes for CLL patients treated with ibrutinib.
KW - anticoagulation
KW - bleeding
KW - chronic lymphocytic leukaemia
KW - European recommendations
KW - ibrutinib
U2 - 10.1111/bjh.15080
DO - 10.1111/bjh.15080
M3 - Journal article
C2 - 29318593
AN - SCOPUS:85040174773
SN - 0007-1048
VL - 180
SP - 666
EP - 679
JO - British Journal of Haematology
JF - British Journal of Haematology
IS - 5
ER -