Changes in primary and secondary hemostasis in patients with CLL treated with venetoclax and ibrutinib
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Changes in primary and secondary hemostasis in patients with CLL treated with venetoclax and ibrutinib. / Svanberg, Rebecka; Ostrowski, Sisse Rye; Nasserinejad, Kazem; Kersting, Sabina; Dobber, Johan A.; Mattson, Mattias; Tran, Hoa T. T.; Levin, Mark-David; Mous, Rogier; Kater, Arnon P.; Niemann, Carsten U.
I: Leukemia and Lymphoma, Bind 61, Nr. 14, 2020, s. 3422-3431.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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T1 - Changes in primary and secondary hemostasis in patients with CLL treated with venetoclax and ibrutinib
AU - Svanberg, Rebecka
AU - Ostrowski, Sisse Rye
AU - Nasserinejad, Kazem
AU - Kersting, Sabina
AU - Dobber, Johan A.
AU - Mattson, Mattias
AU - Tran, Hoa T. T.
AU - Levin, Mark-David
AU - Mous, Rogier
AU - Kater, Arnon P.
AU - Niemann, Carsten U.
PY - 2020
Y1 - 2020
N2 - Bleeding is a common adverse event following ibrutinib monotherapy. However, it remains unclear how hemostasis is affected by venetoclax in combination with ibrutinib. Here we investigated hemostasis in patients with chronic lymphocytic leukemia (CLL) at baseline, during ibrutinib monotherapy, and during venetoclax and ibrutinib combination therapy or venetoclax monotherapy. Primary hemostasis, assessed by Multiplate using adenosine diphosphate (ADP), arachidonic acid (AA), and thrombin receptor agonist peptide (TRAP-6), was impaired in all CLL patients at baseline, remained unchanged upon ibrutinib monotherapy, and improved significantly following venetoclax added to ibrutinib or as monotherapy. Secondary hemostasis assessed by thromboelastography (TEG) was normal and unchanged throughout treatment. The frequency of clinical bleeding events was the highest during ibrutinib monotherapy, in line with the demonstrated improved primary hemostasis upon addition of venetoclax, thus pointing toward a treatment option for CLL patients with increased bleeding risk.
AB - Bleeding is a common adverse event following ibrutinib monotherapy. However, it remains unclear how hemostasis is affected by venetoclax in combination with ibrutinib. Here we investigated hemostasis in patients with chronic lymphocytic leukemia (CLL) at baseline, during ibrutinib monotherapy, and during venetoclax and ibrutinib combination therapy or venetoclax monotherapy. Primary hemostasis, assessed by Multiplate using adenosine diphosphate (ADP), arachidonic acid (AA), and thrombin receptor agonist peptide (TRAP-6), was impaired in all CLL patients at baseline, remained unchanged upon ibrutinib monotherapy, and improved significantly following venetoclax added to ibrutinib or as monotherapy. Secondary hemostasis assessed by thromboelastography (TEG) was normal and unchanged throughout treatment. The frequency of clinical bleeding events was the highest during ibrutinib monotherapy, in line with the demonstrated improved primary hemostasis upon addition of venetoclax, thus pointing toward a treatment option for CLL patients with increased bleeding risk.
KW - CLL
KW - targeted therapy
KW - venetoclax
KW - ibrutinib
KW - hemostasis
KW - bleeding
U2 - 10.1080/10428194.2020.1811270
DO - 10.1080/10428194.2020.1811270
M3 - Journal article
C2 - 32865439
VL - 61
SP - 3422
EP - 3431
JO - Leukemia and Lymphoma
JF - Leukemia and Lymphoma
SN - 1042-8194
IS - 14
ER -
ID: 250556109