{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T22:41:15Z","timestamp":1777934475090,"version":"3.51.4"},"reference-count":12,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2020,10,27]],"date-time":"2020-10-27T00:00:00Z","timestamp":1603756800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Oncol Pharm Pract"],"published-print":{"date-parts":[[2021,7]]},"abstract":"\n Introduction<\/jats:title>\n Ibrutinib is a small molecule inhibitor of Bruton\u2019s tyrosine kinase indicated for the treatment of a variety of B-cell malignancies including chronic lymphocytic leukemia, mantle cell lymphoma, marginal zone lymphoma, and Waldenstrom\u2019s macroglobulinemia. These indolent hematologic malignancies are considered diseases of the elderly, a population that may have dysphagia leading to difficulty swallowing tablets and capsules. Ibrutinib is currently not available in a liquid oral dosage form. We report the utilization and clinical outcomes associated with alternative administration of ibrutinib capsules in a patient with chronic lymphocytic leukemia and significant dysphagia.<\/jats:p>\n <\/jats:sec>\n \n Case report<\/jats:title>\n An 86-year old female requiring chronic lymphocytic leukemia-directed therapy due to a rising absolute lymphocyte count and worsening, transfusion-dependent anemia with a past medical history of dementia and dysphagia, was initiated on ibrutinib.<\/jats:p>\n <\/jats:sec>\n \n Management & outcome<\/jats:title>\n Due to the patient\u2019s significant inability to swallow, ibrutinib capsules were administered via an alternative method by opening them and sprinkling onto soft food or applesauce. With ibrutinib therapy, the patient has had a significant clinical response in her chronic lymphocytic leukemia as evidenced by her decreased absolute lymphocyte count and achieving transfusion independence with improvements in hemoglobin.<\/jats:p>\n <\/jats:sec>\n \n Discussion<\/jats:title>\n Ibrutinib administration via this alternative method resulted in an initial clinical response in the treatment of our patient\u2019s chronic lymphocytic leukemia as evidenced by a decreasing absolute lymphocyte count and improved anemia that achieved transfusion independence. The patient has maintained this response to therapy after approximately 1\u2009year at the time of manuscript preparation.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/1078155220967440","type":"journal-article","created":{"date-parts":[[2020,10,27]],"date-time":"2020-10-27T23:57:08Z","timestamp":1603843028000},"page":"1265-1269","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Ibrutinib treatment via alternative administration in a patient with chronic lymphocytic leukemia and dysphagia"],"prefix":"10.1177","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6942-8353","authenticated-orcid":false,"given":"Kristyn Y","family":"DiSogra","sequence":"first","affiliation":[{"name":"Atrium Health, Specialty Pharmacy Service, Charlotte, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thuy","family":"Tran","sequence":"additional","affiliation":[{"name":"Atrium Health, Specialty Pharmacy Service, Charlotte, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justin R","family":"Arnall","sequence":"additional","affiliation":[{"name":"Atrium Health, Specialty Pharmacy Service, Charlotte, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amanda","family":"Janes","sequence":"additional","affiliation":[{"name":"Atrium Health, Levine Cancer Institute, Concord, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donald C","family":"Moore","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Atrium Health, Levine Cancer Institute, Concord, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven I","family":"Park","sequence":"additional","affiliation":[{"name":"Atrium Health, Levine Cancer Institute, Concord, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2020,10,27]]},"reference":[{"key":"bibr1-1078155220967440","unstructured":"Imbruvica (ibrutinib) [package insert]. Horsham, PA: Janssen Biotech, Inc., April 2020."},{"key":"bibr2-1078155220967440","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2014.107557"},{"key":"bibr3-1078155220967440","first-page":"5761627","volume":"2018","author":"Alsuliman T","year":"2018","journal-title":"Case Rep Hematol"},{"key":"bibr4-1078155220967440","unstructured":"Centers for Disease Control and Prevention, HHS. 2018. NIOSH list of antineoplastic and other hazardous drugs in healthcare settings: Proposed additions to the NIOSH hazardous drug list 2018, www.govinfo.gov\/content\/pkg\/FR-2018-02-14\/pdf\/2018-02957.pdf (accessed 25 September 2020)."},{"key":"bibr5-1078155220967440","unstructured":"Oncology Nursing Society. 2018. Toolkit for safe handling of hazardous drugs for nurses in oncology, www.ons.org\/sites\/default\/files\/2018-06\/ONS_Safe_Handling_Toolkit_0.pdf (accessed 25 September 2020)."},{"key":"bibr6-1078155220967440","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V128.22.5371.5371"},{"key":"bibr7-1078155220967440","doi-asserted-by":"publisher","DOI":"10.1592\/phco.31.2.164"},{"key":"bibr8-1078155220967440","unstructured":"National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology, Chronic Lymphocytic Leukemia\/Small Lymphocytic Lymphoma. Version 4.2020, www.nccn.org\/professionals\/physician_gls\/pdf\/cll.pdf (2019, accessed 30 July 2020)."},{"key":"bibr9-1078155220967440","doi-asserted-by":"publisher","DOI":"10.1038\/s41375-019-0602-x"},{"key":"bibr10-1078155220967440","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1812836"},{"key":"bibr11-1078155220967440","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(18)30788-5"},{"key":"bibr12-1078155220967440","unstructured":"ClinicalTrials.gov. A crossover study to evaluate the bioavailability of ibrutinib suspension and sprinkle formulations compared to capsules in healthy adults. NCT02390609, https:\/\/clinicaltrials.gov\/ct2\/show\/NCT02390609 (accessed 30 July 2020)."}],"container-title":["Journal of Oncology Pharmacy Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1078155220967440","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1078155220967440","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1078155220967440","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T02:24:02Z","timestamp":1777688642000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1078155220967440"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,27]]},"references-count":12,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2021,7]]}},"alternative-id":["10.1177\/1078155220967440"],"URL":"https:\/\/doi.org\/10.1177\/1078155220967440","relation":{},"ISSN":["1078-1552","1477-092X"],"issn-type":[{"value":"1078-1552","type":"print"},{"value":"1477-092X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,27]]}}}