Meet John, living with CLL with ulGHV status
About John
- 78 years old
- Symptoms include:
- Unintentional weight loss
- Increasing fatigue
Medical history
- Mild controlled hypertension
- No previous treatment received for CLL
Physical examination
- Axillary lymphadenopathy
- Spleen palpable approximately 6 cm below costal margin
- Appears chronically ill
- Limited daily activities
Laboratory results
- White blood cell: 47,000 /μL; 76% lymphocytes
- Haemoglobin: 8.7 g/dL
- Platelets: 115,000 mm3/µL
- Absolute neutrophil count: 3,600 mm3/µL
- Lactate dehydrogenase: 250 U/L
- Beta2-macroglobulin: 4.3 mg/L
- Flow cytometry: CD5, CD20, CD23
- FISH: Clonal abnormalities
- Molecular analysis: unmutated IGHV
This is a fictional patient example
![Choose IMBRUVICA® first for patients like John[^1][^2] [^1]: Eichhorst B, <em>et al.</em> Chronic lymphocytic leukaemia: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. <em>Ann Oncol.</em> 2021;32(1):23-33. [^2]: Burger JA, <em>et al.</em> Long-term efficacy and safety of first-line ibrutinib treatment for patients with CLL/SLL: 5 years of follow-up from the phase 3 RESONATE-2 study. <em>Leukemia</em>. 2020;34(3):787–798.](https://eu-images.contentstack.com/v3/assets/blt6b8ca7f1bf9e5733/blt884782257b74875d/636ba8b32d8c1537aef2b352/feature_banner_2.png?width=1920&height=360&format=webp&quality=50)
Choose IMBRUVICA® first for patients like John[1][2]
ESMO guidelines recommend assessing IGHV mutational status before starting treatment[1][3]
Patients carrying an uIGHV experience a more aggressive disease than those with a mIGHV, who follow a more indolent disease course.[4]
Compared to patients with mIGHV status on CIT, patients with the uIGHV subtype are associated with:[5]
Shorter survival from diagnosis[5]
A lower duration of remission[5]
Lower survival rates[5]
IGHV mutational status has a significant impact on survival outcomes with CIT[6][7]
CLL10: PFS by IGHV mutational status with FCR vs. BR in firstline CLL[6]
Adapted from Eichhorst B, et al. 2016.[6]
CLL10: A randomised, open-label, phase III study of FCR vs. BR in fit, previously untreated CLL/SLL patients without del(17p) (N=561); median follow-up 37.1 months.[6]
IMBRUVICA® is proven to significantly prolong PFS in patients with uIGHV CLL[8]*
IMBRUVICA® vs. chlorambucil PFS by mutation status at up to 7 years[8]
Adapted from Ghia P, et al. 2021.[8]
IMBRUVICA® is a preferred firstline treatment in patients with uIGHV CLL[1][9][10]
CLL patient subgroups
uIGHV patients
Genetic aberration patients
Fit patients
Relapsed / refractory patients
Back to IMBRUVICA® studies
Back to IMBRUVICA® efficacy
*Median PFS not reached for IMBRUVICA® at up to 7 years (HR: 0.197 [95% CI: 0.098–0.394])[8]
BR=bendamustine + rituximab; CI=confidence interval; CIT=chemoimmunotherapy; CLL=chronic lymphocytic leukaemia; ESMO=European Society for Medical Oncology; FCR=fludarabine + cyclophosphamide + rituximab; FISH=Fluorescence In Situ Hybridisation; HR=hazard ratio; IGHV=immunoglobulin heavy-chain variable region; iwCLL=International Workshop on Chronic Lymphocytic Leukemia; mIGHV=mutated IGHV; PFS=progression-free survival; SLL=small lymphocytic lymphoma; uIGHV=unmutated IGHV.
