CLL Wonder Drug has a Downside: Weight Gain

 The drug ibrutinib is a highly effective treatment for people with chronic lymphocytic leukemia (CLL), but a new Wilmot Cancer Institute study shows that weight gain, as a drug side effect, should be closely managed to prevent other health problems.

The full report, in the American Journal of Hematology, warns that treatment-related weight gain can have serious consequences for the 40 percent of patients who, before their CLL diagnosis, also have cardiovascular risk factors such as high blood pressure and high cholesterol, and the 15 percent of patients who have diabetes. Two-thirds of the CLL patients in the study were already overweight or obese when ibrutinib treatment began.

The study’s corresponding author, Clive Zent, M.D., said that as the drug reduces the number of energy-wasting CLL tumor cells — a positive impact for the patient — it also increases a person’s appetite.

“When ibrutinib reverses the cancer load, a person ends up eating more but needing less,” Zent said. “Weight management should be an important component of CLL therapy so that we don’t create more problems for the patient.”

In a sample of 118 individuals who were treated for CLL at Wilmot, Zent and his research team tracked how quickly people gained weight on the drug. They discovered that at six months the average weight gain was four pounds and after one year of treatment, patients gained an average of five pounds.  

The weight gain is significant, the study said, because it pushed some patients who were normal weight into the overweight category, or from overweight to obese. The American Institute for suggests that people should maintain a healthy weight by eating a diet rich in fruits, vegetables, whole grains and beans, and staying active.

CLL is more common in older adults, and is the most prevalent type of lymphocytic cancer. More than 85 percent of patients survive five years, due to improved treatments.

The National Cancer Institute and the Cadregari Endowment Fund supported the research.