Major hemorrhage in chronic lymphocytic leukemia patients in the US Veterans Health Administration system in the pre ‐ibrutinib era: Incidence and risk factors

This study included 24  198 CLL patients treated in the VA system before FDA approval of ibrutinib as CLL therapy. Data came from VA databases from 1999 to 2013. MH incidence was 1.9/100 person‐years (95% CI: 1.8‐1.9), with cumulative incidences of 2.3%, 5.2%, and 7.3% by year 1, 3, and 5, respectively. Median time f rom CLL diagnosis to MH was 2.8 years (range: 0‐15.7 years). In multivariate analyses, concurrent anticoagulant and antiplatelet use (HR: 4.2; 95% CI: 3.2‐5.6), anticoagulant use only (HR: 2.6; 95% CI: 2.3‐3.1), and antiplatelet use only (HR: 1.5; 95% CI: 1.3‐1.7) increased MH risk vs not receiving those medications; being nonwhite, male, having MH history, renal impairment, anemia, thrombocytopenia, and alcohol abuse were associated with increased MH risk. These pre‐ibrutinib data are important for providing context for interpreting MH risk in ibrutinib‐treated patients. As ibru tinib clinical use is increasing, updated analyses of MH risk among ibrutinib‐treated VA patients with CLL may provide additional useful insight.
Source: Cancer Medicine - Category: Cancer & Oncology Authors: Tags: ORIGINAL RESEARCH Source Type: research