Medically Reviewed by Dr. Brian Koffman
The Bottom Line:
Long-term ibrutinib treatment increases T cell numbers and improves T cell function in CLL patients but does not fully restore T cell function to normal levels.
Who Performed the Research and Where Was it Presented:
Dr. Jennifer Woyach and colleagues from Ohio State University presented the results at the American Society for Hematology (ASH) Annual Meeting 2023.
Background:
T cells are a type of white blood cell that has several essential roles in the body. T cells help your body fight infections and help your body respond to vaccines. They also help with anti-cancer surveillance in the body. Patients with chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) tend to have “exhausted” T cells, which means that the T cells can’t generate new immune responses anymore. Studies have shown that Bruton tyrosine kinase (BTK) inhibitors such as ibrutinib can make the T cells in CLL patients behave more normally when given for up to one year. Researchers wanted to see if these effects were still seen with long-term ibrutinib treatment.
Methods and Participants:
T-cell samples were obtained from patients with CLL treated with ibrutinib, patients with CLL who were treatment-naïve, and age-matched healthy controls. Samples were taken from patients with CLL at diagnosis, three and five years.
Results
- Patients with CLL on long-term ibrutinib have more T cells, which are better able to proliferate than before ibrutinib treatment.
- While long-term ibrutinib treatment improved T cell function in CLL patients, it was still lower than in treatment-naïve patients and healthy controls.
Conclusion:
Long-term ibrutinib treatment increases T cell numbers and improves T cell function in CLL patients but does not fully restore T cell function to normal healthy levels. While T cell function may not return to normal, these improvements may open the door for other T cell therapies (e.g., bispecific antibodies and CAR-T therapy) in conjunction with ibrutinib or other BTK inhibitors. T cell exhaustion is only one aspect of the broad immune dysfunction seen in CLL that leads to higher rates of serious infections, second cancers, and poor responses to many immune therapies. Finding ways to improve T cell function could be an essential step forward.
Links and Resources:
Watch the interview on the abstract here:
You can read the actual ASH abstract here: T Cell Dysfunction and Exhaustion in Patients with CLL: The Impact of Long Term Ibrutinib Treatment.
Take care of yourself first.
Ann Liu, PhD
