ACALABRUTINIB AND THE POSSIBILITIES OF THERAPY OF CHRONIC LYMPHOCYTIC LEUKEMIA IN SUBSEQUENT LINES IN A COMORBID PATIENT. CLINICAL OBSERVATION

K.V. Menshikov1,2, A.V. Sultanbaev1, Sh.I. Musin1, I.A. Menshikova2, V.S. Chalov3, N.I. Sultanbaeva1, A.Sh. Rezyapova2

1Republican Clinical Oncology Dispensary, Ufa

2Bashkir State Medical University, Ufa

3Center of PET Technology, Center of nuclear Medicine, Ufa

Sultanbaev Aleksandr V. ― Cand. of Sci. (Med.), Head of the Department of Antitumor Drug Therapy of the Republican Clinical Oncology Dispensary

73/1 Oktyabrya Ave., Ufa, 450054, Russian Federation, tel. +7-905-002-22-95, e-mail: rsovaa@rambler.ru, ORCID ID: 0000-0003-0996-5995

Abstract. According to the latest data from the SEER registry, the age-adjusted incidence of chronic lymphocytic leukemia was 4,9 per 100 000 inhabitants per year, making this disease one of the most common types of leukemia. Chronic lymphocytic leukemia is characterized by clonal proliferation and accumulation of mature, usually CD5-positive B cells in the blood, bone marrow, lymph nodes, and spleen. Bruton’s tyrosine kinase plays a significant role in the survival, proliferation, and adhesion of malignant B-lymphocytes in chronic lymphocytic leukemia. Bruton’s tyrosine kinase inhibitors have changed approaches to the treatment of this pathology. Ibrutinib, the first Bruton’s tyrosine kinase inhibitor, is approved for the treatment of chronic lymphocytic leukemia and small cell lymphoma. Acalabrutinib is a new generation irreversible Bruton’s tyrosine kinase inhibitor with proven efficacy in chronic lymphocytic leukemia and small cell lymphoma with a shorter plasma half-life and greater selectivity for Bruton’s tyrosine kinase compared to ibrutinib. A clinical observation of the treatment of a patient with chronic lymphocytic leukemia with severe concomitant pathology is presented. A long-term response was obtained, lasting more than two years on acalobrutinib therapy. The demonstrated clinical observation confirms the effectiveness of acalabrutinib in an elderly patient with a mass of cardiovascular pathology, as well as a minimum number of adverse events.

Key words: chronic lymphocytic leukemia, Bruton’s tyrosine kinase, acalobrutinib, ibrutinib.