IBRUTINIB IN THE MANAGEMENT OF NON-HODGKIN'S LYMPHOMA: A CASE REPORT

Sree Durga Ts; Pavithran K; Uma Devi P

doi:10.22159/ajpcr.2018.v11i12.27983

Authors

Sree Durga Ts Department of Pharmacy Practice, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India.
Pavithran K Department of Medical Oncology and Hematology, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India.
Uma Devi P Department of Pharmacology, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India.

DOI:

https://doi.org/10.22159/ajpcr.2018.v11i12.27983

Keywords:

Nil

Abstract

Non-Hodgkin's lymphoma (NHL) is a diverse group of lymphoid neoplasms, the prevalence of which has increased over the past few decades. NHL is diverse in the manner of presentation, response to various treatment and prognosis. The current case report describes a 40-year-old man who was diagnosed with small lymphocytic lymphoma/chronic lymphocytic leukemia in 2006. The patient had disease progression during the course of 10 years from the time of diagnosis for which he received multiple lines of chemotherapy (chlorambucil/prednisolone; rituximab/cyclophosphamide/ fludarabine; bendamustine/rituximab; and ofatumumab). However, in 2016, his disease again showed signs of progression, and hence he was started on ibrutinib 140 mg 3 times daily. After treatment with ibrutinib, there were no clinical nodes and hepatosplenomegaly, and all counts also normalized. Since the commencement of this agent, no disease progression was observed for almost 16 months. However, in July 2017, again disease progression occurred, and the patient was started on with cyclophosphamide, vincristine, and prednisone (COP) regimen. He received one cycle of COP regimen and continued on treatment with ibrutinib, and the treatment was well tolerated. In December 2017, he expired due to the progression of the disease. Ibrutinib, a Bruton's tyrosine kinase inhibitor, appears to be safe and effective in providing long-term disease control even in refractory cases of NHL.

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Author Biography

Sree Durga Ts, Department of Pharmacy Practice, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India.

Biodata

Name P. Uma Devi

Date of Birth 01.12.1980

Fatherâ€™s Name Prof. K. K. Pillai

Nationality Indian

Marital status Married

Husbandâ€™s name Mr. Mahesh Gopalakrishnan

Present Address AMMASâ€, 2B1, Manor Residency,

Thrikkakara, Ernakulam, Kerala

Mobile Number 09995881579

Email Address umadeviaims@gmail.com.

ACADEMIC RECORD

S. No.

Name of Board/University

Examination Passed

Year

Percentage

Subjects

1.

CBSE

10^th

1997

83.8 (419/500)

English, Hindi, Maths, Science, Social Science

2.

CBSE

12^th

1999

87.2 (436/500)

Physics, Chemistry, Biology, English, Maths

3.

Jamia Hamdard

B. Pharm

2003

81.05 (3769/4650)

Pharmaceutical Science

4.

Jamia Hamdard

M. Pharm (Pharmacology)

2005

86.75 (1041/1200)

Pharmacology

5.

Jamia Hamdard

Ph.D.

2008

Awarded

Pharmacology

DETAILS OF EXPERIENCE IN RESEARCH

During M. Pharm and Ph.D. did research in the area of neuropharmacology. The M. Pharm thesis was entitled Effect of N-acetylcysteine on the antiepileptic efficacy of sodium valproate in miceâ€. The Ph.D. thesis was entitled Analysis of interactions between antiepileptic drugs and N-acetylcysteine on experimental seizures in miceâ€.

WORK EXPERIENCE

Amrita School of Pharmacy (May 2012 â€“ till date)

Presently working as Assistant Professor in Pharmacology at Amrita School of Pharmacy. Mainly involved in teaching Pharmacology to B. Pharm and Pharm D. students & guiding Pharm D students in their research project.

Aim to develop and maintain productive and research oriented methodology in teaching Pharmacology & commitment to mentor graduate students and post graduate students in the research environment at par with present Pharma industry scenario.

Ranbaxy Laboratories Limited (June 2008 â€“ March 2012)

Worked as Research Scientist at Medical Affairs and Clinical Research, Ranbaxy Laboratories Limited, Gurgaon.

Job Profile

Preparation and review of clinical trial protocols and related referenced documents (e.g., investigatorâ€™s brochure, informed consent document, case report form etc)
Preparation and review of clinical study reports including tables, listings and figures
Preparation of manuscripts for the completed clinical trials
Providing timely inputs on the efficacy and safety of clinically used drugs and drugs under various stages of clinical development
Participation in the editorial activities of Ranbaxy Science Foundation including the editing of the Proceedings of Symposia
Preparation and review of Standard Operating Procedures

PUBLICATIONS

1. P. Uma Devi, P. Saraogi, A. Manocha, Divya Vohora. Pharmacological and biochemical analysis of interactions between N-Acetylcysteine and some antiepileptic drugs on experimental seizures in mice. CNS Neuroscience & Therapeutics 2012 May; 18(5):406-13. [Impact factor: 4.443].

2. Devi PU, Manocha A, Vohora D. Seizures, antiepileptics, antioxidants and oxidative stress: an insight for researchers. Expert Opin Pharmacother. 2008 Dec; 9(18): 3169-77 (Impact factor: 3.205).

3. Devi PU, Pillai KK, Vohora D. Facilitation action of N-acetylcysteine on the anticonvulsant effect of sodium valproate in mice. Basic Clin Pharmacol Toxicol. 2006 May; 98(5): 521-2 (Impact factor: 2.18).

4. Uma Devi P, Pillai KK, Vohora D. Modulation of pentylenetetrazole-induced seizures and oxidative stress parameters by sodium valproate in the absence and presence of N-acetylcysteine. Fundam Clin Pharmacol. 2006 Jun; 20(3): 247-53 (Impact factor: 1.799).

Note: This research paper was amongst the top ten most web assessed papers of the journal for the year 2006.

5. Uma Devi P, Manocha A, Khanam R, Vohora D. Beneficial interaction between clobenpropit and pyridoxine in prevention of electroshock-induced seizures in mice: lack of histaminergic mechanisms. Hum Exp Toxicol. 2011 Jan; 30(1): 84-8 (Impact factor: 1.772).

FELLOWSHIPS/SCHOLARSHIPS/AWARDS RECEIVED

1. Hakeem Abdul Majeed Scholarship from Jamia Hamdard University for 3 consecutive years for securing the highest marks in the Annual Examinations of B. Pharm 1^st year (2000), 2^nd year (2001) and 3^rd year (2002)
2. Awarded the University Gold Medal for standing first at the B. Pharm Examination 2003
3. Fellowship from UGC during M. Pharmacy Programme of study (Percentile in GATE 2003 exam: 99.86; All India Rank: 7)
4. Awarded the University Gold Medal for standing first at the M. Pharm (Pharmacology) Examination 2005
5. Appointed as Project Fellow under the UGC project entitled Selective histamine H3 receptor ligands, brain histamine and intrasynaptosomal calcium as novel tools to study neuropsychiatric disordersâ€ (2005)
6. Ranbaxy On the Spot Awardâ€ for preparing a clinical study report without any observations from Quality Assurance
7. Received a Certificate of Recognition from Jamia Hamdard on National Science Day in recognition of my research work and its publication in high impact factor journal published in the year 2012.

CONFERENCES/SEMINARS/SYMPOSIA ATTENDED

1. Training Programme on Guiding principles for pharmacists â€“ HIV/AIDS in India and update on newer drug development for HIV/AIDS and in ocular pharmacologyâ€ held at AIIMS, New Delhi (7^th September, 2003)
2. 36^th Annual Conference of the Indian Pharmacological Society organized by Vallabhbhai Patel Chest Institute, Delhi (5^th-7^th December, 2003)
3. Intellectual property rights awareness seminar on pharmaceuticals organized by Faculty of Pharmacy, Jamia Hamdard (26^th February, 2005)
4. National Conference on Infectious Diseases 2005â€ organized by Department of Medicine, Sir Ganga Ram Hospital, New Delhi (17^th-18^th December, 2005)
5. International Symposium on Herbal drug research and therapyâ€ organized by Vallabhbhai Patel Chest Institute, Delhi (9^th-10^th December, 2006)
6. A Multidisciplinary Symposium-cum-Workshop on Therapeutic drug monitoring for better therapeutics & drug developmentâ€ organized by Departments of Pharmacology & Nephrology, AIIMS, New Delhi (2^nd-3^rd February, 2007)
7. International Symposium on Recent advances in cardiovascular sciencesâ€ organized by Delhi Institute of Pharmaceutical Sciences & Research (14^th-15^th February, 2007)
8. Indo-US Symposium on Novel therapeutic approaches for the treatment of neurological disordersâ€ organized by Department of Pharmacology, AIIMS, New Delhi (19^th November, 2007)
9. Investigator Meeting for Proof of Concept Study of RBx10017609 at Ranbaxy R&D, Gurgaon (14^th-15^th February, 2011)

10.Participated in a scientific session Genetically modified crops and food security â€“ Issues and Prospectsâ€ organized by University College of Pharmacy, Mahatma Gandhi University, Regional Institute of Medical Sciences and Research, Puthupally Campus, sponsored by Kerala State Council for Science, Technology and Environment (16^th February, 2013).

TRAINING ATTENDED

Attended Teacherâ€™s Training Program at Amrita School of Medical Sciences from 24^th â€“ 27^th April 2013.