Ibrutinib is an oral drug used to treat several B-cell malignancies and chronic graft-versus-host disease. Treon and colleagues recently published in Blood a report on six Waldenström’s patients who had been taking ibrutinib for several years and who had recently contracted COVID-19. All the patients experienced cough and fever. Five of the patients, who were taking a standard dose of ibrutinib, had no shortness of breath, did not need to be hospitalized, and steadily improved.
The sixth patient, who had been taking a lower dose of ibrutinib because of side effects, experienced worsening symptoms of shortness of breath and initially was taken off ibrutinib and treated with other drugs. After 10 days he was placed on a ventilator, and doctors decided to re-start ibrutinib at the standard dose the other patients had been taking. He rapidly improved, was removed from the ventilator, and on day 14 was discharged from the hospital to his home, where he continues to do well on the standard dose of ibrutinib. “These experiences have given us the inspiration to do prospective randomized trials of ibrutinib and a similar drug, zanubrutinib in COVID-19 patients in respiratory distress,” said Treon.
