Lack of adequate pneumococcal vaccination response in chronic lymphocytic leukaemia patients receiving ibrutinib

Andrick, Benjamin; Alwhaibi, Abdulrahman; DeRemer, David L.; Quershi, Sameera; Khan, Rahil; Bryan, Locke J.; Somanath, Payaningal R.; Pantin, Jeremy

doi:10.1111/bjh.14855

Cited by 40 publications

(26 citation statements)

References 8 publications

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“…Guidelines recommend vaccination against influenza and pneumococcal disease in patients with B-cell malignancies [73, 108]. However, recent prospective data demonstrate that ibrutinib may dramatically impair adequate serological responses to vaccination [109, 110]; hence, clinicians may consider vaccinating patients before the initiation of antineoplastic therapy.…”

Section: Molecular Targeted Agents (Ibrutinib Idelalisib Hdac Inhibmentioning

confidence: 99%

Infections associated with immunotherapeutic and molecular targeted agents in hematology and oncology. A position paper by the European Conference on Infections in Leukemia (ECIL)

et al. 2019

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A multitude of new agents for the treatment of hematologic malignancies has been introduced over the past decade. Hematologists, infectious disease specialists, stem cell transplant experts, pulmonologists and radiologists have met within the framework of the European Conference on Infections in Leukemia (ECIL) to provide a critical state-of-the-art on infectious complications associated with immunotherapeutic and molecular targeted agents used in clinical routine. For brentuximab vedotin, blinatumomab, CTLA4- and PD-1/PD-L1-inhibitors as well as for ibrutinib, idelalisib, HDAC inhibitors, mTOR inhibitors, ruxolitinib, and venetoclax, a detailed review of data available until August 2018 has been conducted, and specific recommendations for prophylaxis, diagnostic and differential diagnostic procedures as well as for clinical management have been developed.

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Section: Molecular Targeted Agents (Ibrutinib Idelalisib Hdac Inhibmentioning

confidence: 99%

Infections associated with immunotherapeutic and molecular targeted agents in hematology and oncology. A position paper by the European Conference on Infections in Leukemia (ECIL)

et al. 2019

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“…A subsequent study looking at 13 relapsed CLL patients on ibrutinib for median 7.5 months found no responders to influenza vaccine 52 . A similar study of 13-valent pneumococcal conjugate vaccination (PCV-13) found that all four untreated patients responded, while none of the four ibrutinib patients did, suggesting that if possible to vaccinate prior to starting ibrutinib, this is preferred 53 . My practice is to vaccinate prior to ibrutinib if feasible, but if not, to still provide vaccinations to patients on ibrutinib, as data are limited and any response is helpful.…”

Section: Infections and Prophylaxis (Including Vaccines)mentioning

confidence: 99%

How I treat CLL patients with ibrutinib

Brown

2018

Blood

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Ibrutinib is a transformative therapy for high-risk and relapsed refractory chronic lymphocytic leukemia (CLL) patients. In clinical trials in relatively healthy younger patients, ibrutinib has been well tolerated. As its use has become more widespread in the community, however, its full adverse event profile has emerged and proven more challenging than was initially anticipated. Reports of community-based use have estimated discontinuation rates as high as 40% in the first year of therapy. This article therefore reviews my approach to the evaluation and management of a CLL patient starting on ibrutinib, with the goal of minimizing and managing toxicity to maintain patients on ibrutinib. Key topics discussed include bleeding risk; cardiac complications, particularly atrial fibrillation; drug interactions; and infections.

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“…Eight studies evaluated responses to PCV13 in patients with hematologic malignancies, including leukemia, MM, and mixed hematological disorders. [33][34][35][36][37][38][39][40]…”

Section: Hematologic Conditionsmentioning

confidence: 99%

“…All control patients with CLL not taking ibrutinib met the defined antibody response to PCV13 (≥2-fold increase in postvaccination IgG concentrations for three or more serotypes), but responses were not observed in the four patients being treated with ibrutinib. 35…”

Section: Leukemiamentioning

confidence: 99%

Immunogenicity and safety of the 13-valent pneumococcal conjugate vaccine in patients with immunocompromising conditions: a review of available evidence

Chilson

Scott

Schmöele-Thoma

et al. 2020

Human Vaccines & Immunotherapeutics

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Lack of adequate pneumococcal vaccination response in chronic lymphocytic leukaemia patients receiving ibrutinib

Cited by 40 publications

References 8 publications

Infections associated with immunotherapeutic and molecular targeted agents in hematology and oncology. A position paper by the European Conference on Infections in Leukemia (ECIL)

Infections associated with immunotherapeutic and molecular targeted agents in hematology and oncology. A position paper by the European Conference on Infections in Leukemia (ECIL)

How I treat CLL patients with ibrutinib

Immunogenicity and safety of the 13-valent pneumococcal conjugate vaccine in patients with immunocompromising conditions: a review of available evidence

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