Atrial fibrillation in CLL patients treated with ibrutinib. An international retrospective study

• DOI: 10.1111/bjh.14324
• Publication Date: 2016-09-09T16:22:18Z
• Authors: Philip A. Thompson; Vincent Lévy; Constantine S. Tam; Chadi Al Nawakil; François‐Xavier G...; Anne Quinquenel; Loic Ysebaert; Anne‐Sophie Micha...; Marie‐Sarah Dilhuydy; Eric Van Den Neste; Jehan Dupuis; Michael J. Keating; Christophe Meune; Florence Cymbalista
• Keywords: Aged, 80 and over; Male; Adenine; Disease Management; Antineoplastic Agents; Hemorrhage; Middle Aged; Leukemia, Lymphocytic, Chronic, B-Cell; 3. Good health; 03 medical and health sciences; Pyrimidines; 0302 clinical medicine; Piperidines; Atrial Fibrillation; Humans; Pyrazoles; Female; Protein Kinase Inhibitors; Aged; Retrospective Studies

SummaryAtrial 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.