Atrial fibrillation in CLL patients treated with ibrutinib. An international retrospective study.
Atrial fibrillation (AF) occurs in 5-9% of patients treated with ibrutinib for chronic lymphocytic leukaemia (CLL); the clinical consequences and optimal management are unclear. We retrospectively studied 56 CLL patients who received ibrutinib and developed AF. Median time to onset was 3·8 months. AF was persistent in 35/56 (62%) cases despite treatment. Clinical consequences included: three episodes of severe cardiac failure (one fatal) and one stroke; eight non-thrombocytopenic patients (14%) experienced severe bleeding adverse events. Altogether, ibrutinib was permanently discontinued in 26/56 cases (46%). Data to guide optimal management are lacking and clinical practice guidelines are urgently needed.
Department of Leukemia, The University of Texas, M.D. Anderson Cancer Center, Houston, TX, USA.
Philip A
PA
Thompson
URC/CRC, GHUPSSD, AP-HP, INSERM U1153, Université Paris 13, Bobigny, France.
Vincent
V
Lévy
Department of Haematology and Medical Oncology, The Peter MacCallum Cancer Centre, East Melbourne, Vic., Australia.
Constantine S
CS
Tam
URC/CRC, GHUPSSD, AP-HP, INSERM U1153, Université Paris 13, Bobigny, France.
Chadi
C
Al Nawakil
Department of Cardiology, GHUPSSD, AP-HP, INSERM UMR s-942, Université Paris 13, Bobigny, France.
François-Xavier
FX
Goudot
Service Hématologie Clinique, Hopital Robert Debré, CHU Reims, Reims, France.
Anne
A
Quinquenel
Service d'Hématologie, IUCT-Oncopole, Toulouse, France.
Loic
L
Ysebaert
Centre Léon Bérard, Lyon, France.
Anne-Sophie
AS
Michallet
Service d'hématologie, Hopital Haut Leveque, Pessac, France.
Marie-Sarah
MS
Dilhuydy
Department of Haematology, Cliniques universitaires UCL Saint-Luc, Brussels, Belgium.
Eric
E
Van Den Neste
Lymphoid Malignancies Unit, Henri Mondor University Hospital, Créteil, France.
Jehan
J
Dupuis
Department of Leukemia, The University of Texas, M.D. Anderson Cancer Center, Houston, TX, USA.
Michael J
MJ
Keating
Department of Cardiology, GHUPSSD, AP-HP, INSERM UMR s-942, Université Paris 13, Bobigny, France.
Christophe
C
Meune
Service d'Hématologie Biologique, GHUPSSD, AP-HP, U978 INSERM, Université Paris 13, Sorbonne Paris Cité, Labex Inflamex, Bobigny, France. florence.cymbalista@avc.aphp.fr.
Florence
F
Cymbalista
D000225:Adenine / Q000031:analogs & derivatives; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D019468:Disease Management; D005260:Female; D006470:Hemorrhage / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000150:complications* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D010880:Piperidines; D047428:Protein Kinase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D011720:Pyrazoles / Q000009:adverse effects* / Q000627:therapeutic use; D011743:Pyrimidines / Q000009:adverse effects* / Q000627:therapeutic use; D012189:Retrospective Studies
D000970:Antineoplastic Agents; D010880:Piperidines; D047428:Protein Kinase Inhibitors; D011720:Pyrazoles; D011743:Pyrimidines; C551803:ibrutinib; D000225:Adenine
atrial fibrillation; chronic lymphocytic leukaemia; ibrutinib