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Outcomes of Patients With Chronic Lymphocytic Leukemia Treated With Bruton Tyrosine Kinase Inhibitors (BTKi): A Retrospective Study From a Tertiary Healthcare Center in North India

Year: 2026

Type: article

Abstract: BACKGROUND AND OBJECTIVES: Bruton tyrosine kinase inhibitors (BTKi) are a pivotal advancement in treating chronic lymphocytic leukemia (CLL). However, their adoption faces challenges such as high discontinuation rates caused by adverse events like cardiac and hematologic toxicities and a significant financial burden. Our study aims to evaluate the clinical spectrum and outcomes of patients with CLL receiving BTKi therapy in India. The objectives are to evaluate progression-free survival and overall survival in CLL patients on BTKi and to assess the BTKi toxicity profile. MATERIALS AND METHODS: This retrospective, single-center study analyzed data from 41 patients with CLL treated with BTKi between January 2019 and November 2024. RESULTS: Twenty-five male patients and 16 female patients were evaluated, with a median age of 64 years (range 42-90). Twelve patients (29.2%) had no cytogenetic abnormalities, while 29 (70.7%) had at least one abnormality; 13q deletion was the most common. BTKi was used as first-line therapy in 29 patients (70.7%), with acalabrutinib being the most commonly used agent, administered to 17 (58.6%) patients. Cardiac events were observed in 8 (19.5%) patients, including hypertension in four (9.7%) and atrial fibrillation in two (4.9%). Gastrointestinal adverse events were noted in 7 (17%) patients. One patient had Richter transformation to diffuse large B-cell lymphoma. At a median follow-up of 24 months, progression-free survival was 80% and overall survival was 95%. CONCLUSIONS: BTKi therapy is effective and well tolerated in Indian CLL patients, but early discontinuation highlights the need for improved adherence strategies.

Source: Cureus

DOI: 10.7759/cureus.117629