Acalabrutinib has no detrimental effect on immune thrombocytopenia (ITP) associated with chronic lymphocytic leukemia, according to a case study published in the journal Leukemia & Lymphoma. This result suggests that the treatment could be an option for patients with chronic lymphocytic leukemia complicated by ITP, the researchers said.
They reported that a phase 2 clinical trial evaluating the efficacy of the treatment in relapsed or refractory autoimmune hemolytic anemia in chronic lymphocytic leukemia has now completed recruiting participants and that preliminary results are expected at the end of the year.
Read more about the different types of ITP
The effect of targeted agents such as Bruton’s tyrosine kinase inhibitors like acalabrutinib and B-cell lymphoma 2 inhibitors on autoimmune cytopenias, including ITP associated with chronic lymphocytic leukemia, is controversial. This is because these patients were excluded from the pivotal clinical trials testing these treatments.
In the present study, researchers from the UK presented the case of an 85-year-old male with chronic lymphocytic leukemia-associated ITP who had a sustained platelet response to acalabrutinib treatment. The patient was unsuitable for corticosteroid therapy due to concurrent glaucoma. and initially responded to romiplostim, a thrombopoietin receptor agonist.
However, once the treatment was discontinued, ITP relapsed, which is when acalabrutinib treatment was initiated at a dose of 100 mg twice a day. This led to a rapid resolution of his bleeding symptoms and lymphadenopathy, as well as a progressive and sustained increase in his platelet count.
Acalabrutinib is a selective, next-generation Bruton’s tyrosine kinase inhibitor approved for patients
with treatment-naive and relapsed chronic lymphocytic leukemia. Its impact on the clinical outcome of autoimmune cytopenias, including ITP associated with chronic lymphocytic leukemia, is not clear.
ITP is a rare bleeding disorder characterized by an unusually low platelet count, often below 100,000/µL. The disease can develop secondary to lymphoproliferative diseases, especially chronic lymphocytic leukemia, among others.
Reference
Allsup D, Molica S. Acalabrutinib is an effective treatment for immune thrombocytopenia associated with chronic lymphocytic leukemia, a case report. Leuk Lymphoma. Published online April 11, 2023. doi:10.1080/10428194.2023.2199341
