EXPERIENCE WITH IBRUTINIB IN PATIENTS WITH REFRACTORY AND RECURRENT B-CELL CHRONIC LYMPHOCYTIC LEUKEMIA

Purpose of the study. To obtain experience with ibrutinib in patients with chronic lymphocytic leukemia (CLL) in everyday clinical practice.Material and methods. 20 patients with refractory or relapsed CLL were included in the study during the period from October 2015 to January 2016. Immunophenotyping, cytogenetic and molecular tests of peripheral blood samples were performed for all patients. Patients took ibrutinib at dose of 420 mg once daily for a year or until progression. The effectiveness of treatment was assessed by overall response rate, complete response and overall survival.Results. The overall response rate was 100%. The overall survival rate at 14 months was 80%. The complete response rate at 14 months after initiation of therapy was 60%. The primary effect was observed in lymph nodes, while changes in the hemogram occurred later. The medicine was well tolerated. Patients who stopped ibrutinib therapy therapy due to complications, restarted treatment at full dose after resolving.Conclusion. Ibrutinib is a highly effective medicine for patients with refractory or relapsed CLL, including those from the highrisk group, but it is not a «salvage therapy» and is not effective at terminal states. Ibrutinib can be considered as a «bridge» for young patients who are candidates for allogeneic bone marrow transplantation.