No increased bleeding events in patients with relapsed chronic lymphocytic leukemia and indolent non-Hodgkin lymphoma treated with idelalisib.

Abstract

The advent of novel B-cell receptor pathway targeting agents like ibrutinib dramatically changed management of B-cell malignancies. However, with concomitant anticoagulation (AC) and antiplatelet (AP) therapy, ibrutinib is associated with increased bleeding. This post hoc analysis aimed to determine the role of AC/AP therapy in patients with idelalisib-treated B-cell malignancies and to establish if it contributes to increased bleeding events. Data from two idelalisib trials (rituximab ± idelalisib in chronic lymphocytic leukemia [CLL] and idelalisib monotherapy in indolent non-Hodgkin lymphoma [iNHL]) were analyzed. Antithrombotic therapy was common (36%-63%), with comparable bleeding incidence across treatment groups (14%-19%; p = 0.56). Bleeding events of grade ≥3 occurred in 0.9% and 3.2% of the idelalisib-treated CLL and iNHL cohorts, respectively. Our findings demonstrate no increase in bleeding events with simultaneous AC/AP treatment and idelalisib use. Hemorrhagic risk is prevalent in these patients and an important consideration when evaluating available treatment options. ClinicalTrials.gov identifiers: NCT01539512 and NCT01282424.

• Authors: Jacqueline C Barrientos, Peter Hillmen, Gilles Salles, Jeff Sharman, Stephan Stilgenbauer, Oksana Gurtovaya, Guan Xing, Bianca Ruzicka, Pankaj Bhargava, Paolo Ghia, John M Pagel
• Journal: Leukemia & lymphoma (Leuk Lymphoma) Vol. 62 Issue 4 Pg. 837-845 (04 2021) ISSN: 1029-2403 [Electronic] United States
• PMID: 33297794 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Chemical References

• Antineoplastic Agents
• Purines
• Quinazolinones
• idelalisib

Topics

• Antineoplastic Agents (adverse effects)
• Humans
• Leukemia, Lymphocytic, Chronic, B-Cell (complications, drug therapy)
• Lymphoma, Non-Hodgkin (complications, drug therapy)
• Purines (adverse effects)
• Quinazolinones (adverse effects)