Ibrutinib in combination with rituximab is highly effective in treatment of chronic lymphocytic leukemia patients with steroid refractory and relapsed autoimmune cytopenias

A multicenter study was conducted to assess the efficacy of ibrutinib and rituximab in treating steroid-refractory autoimmune hemolytic anemia (AIHA) and pure red cell aplasia (PRCA) in patients with underlying chronic lymphocytic leukemia (CLL). The protocol involved an induction phase with ibrutinib and rituximab, followed by a maintenance phase with ibrutinib alone. Out of the 50 recruited patients, 74% achieved a complete response and 21.7% had a partial response after the induction phase. The median time for hemoglobin normalization was 85 days. In terms of CLL response, 19% achieved complete response, 4% had stabilization, and 78% achieved a partial response. The most common adverse events observed were neutropenia, infections, and gastrointestinal complications. Overall, the combination of ibrutinib and rituximab appears to be a promising second-line treatment option for patients with relapsed or refractory AIHA/PRCA and underlying CLL.