First Report of Treatment of Chronic Lymphocytic Leukemia in a Patient With Cystic Fibrosis

Abstract

Patients with cystic fibrosis (CF) are known to have an increased risk of developing hematological malignancies. Despite this, there is a paucity of evidence to guide treatment decisions in this population, which requires special consideration due to patients risk of developing infection and baseline relative immunosuppression. There are 11 prior published reports of treatment of hematological malignancy in CF, and no reports of treatment of chronic lymphocytic leukemia (CLL). We report the first case of treatment of CLL in a 51-year-old male with CF. He was successfully treated with bendamustine concomitantly with prophylactic antibiotics, antifungals, and intravenous immunoglobulin (IVIG). He obtained a complete remission (CR) without any infectious complications. Following this, he relapsed and was treated to near CR with ibrutinib and monthly IVIG, with manageable infectious complications. We have shared this case with a view to contribute to the literature in this area. In particular, we have demonstrated that achieving CR in CLL without infectious complications is possible using bendamustine monotherapy, prophylactic antibiotics, and IVIG. Second, we have showed that achieving significant response with manageable infectious complications is possible with ibrutinib monotherapy and monthly IVIG.




J Med Cases. 2017;8(1):20-23
doi: https://doi.org/10.14740/jmc2708w