Do Age, Fitness and Concomitant Medications Influence Management and Outcomes of CLL Patients Treated with Ibrutinib?

• Published in: Blood 2020-11, Vol.136 (Supplement 1), p.54-55
• Main Authors: Tedeschi, Alessandra, Frustaci, Anna Maria, Mauro, Francesca Romana, Chiarenza, Annalisa, Coscia, Marta, Ciolli, Stefania, Reda, Gianluigi, Laurenti, Luca, Varettoni, Marzia, Murru, Roberta, Baratè, Claudia, Sportoletti, Paolo, Greco, Antonino, Borella, Chiara, Rossi, Valentina, Deodato, Marina, Biagi, Annalisa, Curto Pelle, Angelo, Lapietra, Gianfranco, Vitale, Candida, Morelli, Francesca, Cassin, Ramona, Fresa, Alberto, Flospergher, Elena, Postorino, Massimiliano, Di Prima, Alessio, Cairoli, Roberto, Di Raimondo, Francesco, Montillo, Marco, Del Poeta, Giovanni
• Format: Article
• Language: English
• ISSN: 0006-4971; 1528-0020
• DOI: 10.1182/blood-2020-137024

Background Chronic lymphocytic leukemia (CLL) is a disease of the elderly. Advancing age is associated with greater vulnerability, increasing treatment side effects and reduced survival with chemoimmunotherapy (CIT). Comorbidities burden, Charlson Comorbidity Index (CCI) and Cumulative Illness Rating Scale (CIRS) scores emerged as reliable tools in trials with patients (pts) receiving CIT. Ibrutinib changed CLL treatment paradigm. Nevertheless, adverse events leading to dose reductions and discontinuations are frequent in everyday practice. Finally, it is still unclear whether age, ECOG and comorbidities retain a predictive value with ibrutinib and if number and types of concomitant medications may interfere with treatment outcome. Methods This multicenter retrospective analysis evaluated 712 pts in 15 Italian centers treated with ibrutinib from March 2014 to May 2020. We analyzed the impact of age (6), major CIRS comorbidity (at least one organ with a CIRS score ≥3, CIRS3+), ECOG (0-1 vs >1) and CCI (6, CIRS3+, ECOG >1 and CCI ≥2, showed to be