The time to lymphocyte count normalization was significantly shorter in patients randomized to ibrutinib plus rituximab compared with ibrutinib alone (3.0 vs 8.9 months; P
<.001). Hemoglobin and platelet counts improved similarly in both groups. According to Burger, there was a trend toward a faster normalization of immunoglobulin levels and T-cell counts in patients on combination therapy, “which may mirror the fact that these patients achieve remissions faster than patients treated with single-agent ibrutinib.” The faster peripheral blood clearance and deeper remissions in patients treated with rituximab plus ibrutinib indicates that ibrutinib does not antagonize rituximab in the clinical setting.
He concluded, “we cannot exclude that longer follow-up of treatment with anti-CD20 antibodies for a longer period of time or with different anti-CD20 antibodies may have a positive impact on PFS and OS.” Reference
Burger JA, Sivina M, Ferrajoli A, et al. Randomized trial of ibrutinib versus ibrutinib plus rituximab in patients with chronic lymphocytic leukemia (CLL). Presented at: American Society of Hematology 59th Annual meeting; December 9-12, 2017; Atlanta, GA. Abstract 427. https://ash.confex.com/ash/2017/webprogram/Paper107661.html.