BTK

Chr X

Bruton tyrosine kinase

Also known as: AGMX1, AT, ATK, BPK, IGHD3, IMD1, PSCTK1, XLA

The protein encoded by this gene plays a crucial role in B-cell development. Mutations in this gene cause X-linked agammaglobulinemia type 1, which is an immunodeficiency characterized by the failure to produce mature B lymphocytes, and associated with a failure of Ig heavy chain rearrangement. Alternative splicing results in multiple transcript variants encoding different isoforms. [provided by RefSeq, Dec 2013]

GeneReviewsResearchGenerating clinical summary…

Primary Disease Associations & Inheritance

UniProtX-linked agammaglobulinemia
UniProtGrowth hormone deficiency, isolated, 3, with agammaglobulinemia

Clinical highlights

Gene-disease validity (ClinGen)
isolated growth hormone deficiency type III · XLDisputedevidence questions this relationship2 gene-disease associations curated in total
Interpreting a novel variant
This gene is strongly intolerant of loss-of-function variation in the population, so LoF variants warrant close attention. No curated mechanism annotation is available — see the mechanism card for the computational prediction and its caveats.Based on population constraint only.
12
Active trials
909
Pubs (1 yr)
P/LP submissions
P/LP missense
0.10
LOEUF· LoF intol.
LOF
Mechanism· predicted
📖
GeneReview available — BTK
Authoritative clinical overview · Recommended first read
Open GeneReview ↗
Some data sources returned errors (1)

omim: Error: OMIM fetch failed: 429

Population Genetics & Constraint

gnomAD v4 — loss-of-function & missense intolerance

Dual constrained — LoF & missense intolerant
LoF Constraint?
0.10LOEUF
pLI 1.000
Z-score 4.99
OE 0.00 (0.000.10)
Highly constrained

Among the most LoF-intolerant genes (~top 3%)

Missense Constraint?
4.04Z-score
OE missense 0.28 (0.230.35)
72 obs / 252.7 exp
Constrained

Highly missense-constrained (top ~0.1%)

Observed / Expected Ratios?
LoF OE?0.00 (0.000.10)
00.351.4
Missense OE?0.28 (0.230.35)
00.61.4
Synonymous OE?0.82
01.21.6
LoF obs/exp: 0 / 29.0Missense obs/exp: 72 / 252.7Syn Z: 1.34

ClinVar Variant Classifications

0 submitted variants in ClinVar

Protein Context — Lollipop Plot

BTK · protein map & ClinVar variants

Showing all ClinVar variants across the protein. Search a specific variant to highlight its position.

Clinical Trials

Active and recruiting trials from ClinicalTrials.gov

Recurrent Chronic Lymphocytic Leukemia/Small Lymphocytic LymphomaRefractory Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma

Nemtabrutinib and Lisocabtagene Maraleucel for the Treatment of Relapsed/Refractory Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma

RECRUITING
NCT07194980Phase PHASE2Fred Hutchinson Cancer CenterStarted 2026-09-01
NemtabrutinibLisocabtagene Maraleucel
Chronic Lymphocytic LeukemiaSmall Lymphocytic Lymphoma

Acalabrutinib With or Without Obinutuzumab in Treating Patients With Early-Stage Chronic Lymphocytic Leukemia or Small Lymphocytic Lymphoma

RECRUITING
NCT03516617Phase PHASE2Mayo ClinicStarted 2018-09-10
AcalabrutinibLaboratory Biomarker AnalysisObinutuzumab
Recurrent Mantle Cell LymphomaRefractory Mantle Cell Lymphoma

Nemtabrutinib With CAR T Therapy in Relapsed/Refractory Mantle Cell Lymphoma

RECRUITING
NCT07673367Phase PHASE2Vanderbilt-Ingram Cancer CenterStarted 2026-07-31
NemtabrutinibBrexucabtagene autoleucel ( other names: brexu-cel , Tecartus)
B-cell MalignancyChronic Lymphocytic LeukemiaSmall Lymphocytic Lymphoma

AS-1763 in Patients With Previously Treated CLL/SLL or Non-Hodgkin Lymphoma

RECRUITING
NCT05602363Phase PHASE1Carna Biosciences, Inc.Started 2023-08-01
Docirbrutinib
Chronic Lymphocytic LeukemiaBTK Degraders

Determinants of the Response to BTK Degraders (BTKd) in Chronic Lymphocytic Leukemia

RECRUITING
NCT07099443Nantes University HospitalStarted 2025-10-09
Non-Interventional Sample Collection and Analysis
Recurrent Transformed Chronic Lymphocytic LeukemiaRefractory Transformed Chronic Lymphocytic LeukemiaTransformed Chronic Lymphocytic Leukemia to Diffuse Large B-Cell Lymphoma

Zanubrutinib and Lisocabtagene Maraleucel for the Treatment of Richter's Syndrome

RECRUITING
NCT05873712Phase PHASE2Aseel AlsouqiStarted 2023-07-28
Biospecimen CollectionBone Marrow BiopsyComputed Tomography
Chronic Spontaneous Urticaria (CSU)Hidradenitis Suppurativa (HS)Psoriasis (PsO)

SKIN Disease Profiling by an Exploratory, pRospective, Biomarker Study in dermatoloGY Practice (SKINERGY)

RECRUITING
NCT07021495Leiden University Medical CenterStarted 2025-07-29
Diffuse Large B-Cell Lymphoma Associated With Chronic InflammationEBV-Positive Diffuse Large B-Cell Lymphoma, Not Otherwise SpecifiedHigh Grade B-Cell Lymphoma, Not Otherwise Specified

Zanubrutinib and CAR T-cell Therapy for the Treatment of Recurrent or Refractory Aggressive B-cell Non-Hodgkin's Lymphoma or Transformed Indolent B-cell Lymphoma

ACTIVE NOT RECRUITING
NCT05202782Phase PHASE2Northwestern UniversityStarted 2022-03-21
Chimeric Antigen Receptor T-Cell TherapyQuality-of-Life AssessmentQuestionnaire Administration
AIDS-Related LymphomaAnn Arbor Stage II Diffuse Large B-Cell LymphomaAnn Arbor Stage III Diffuse Large B-Cell Lymphoma

Ibrutinib, Rituximab, Etoposide, Prednisone, Vincristine Sulfate, Cyclophosphamide, and Doxorubicin Hydrochloride in Treating Patients With HIV-Positive Stage II-IV Diffuse Large B-Cell Lymphomas

ACTIVE NOT RECRUITING
NCT03220022Phase PHASE1National Cancer Institute (NCI)Started 2018-03-16
CyclophosphamideDoxorubicin HydrochlorideEtoposide
Diffuse Large B Cell Lymphoma (DLBCL)

Orelabrutinib in Combination with R-CHOP for CD5-positive DLBCL Patients(Rocket Trial)

RECRUITING
NCT06647940Phase PHASE2Sun Yat-sen UniversityStarted 2024-11-01
Orelabrutinib Oral TabletR-CHOP Protocol
Recurrent Diffuse Large B-Cell Lymphoma Activated B-Cell TypeRefractory Diffuse Large B-Cell Lymphoma Activated B-Cell Type

Ibrutinib Before and After Stem Cell Transplant in Treating Patients With Relapsed or Refractory Diffuse Large B-cell Lymphoma

ACTIVE NOT RECRUITING
NCT02443077Phase PHASE3National Cancer Institute (NCI)Started 2016-10-12
Autologous Bone Marrow TransplantationAutologous Hematopoietic Stem Cell TransplantationCarmustine
Waldenstrom's DiseaseWaldenstrom Macroglobulinemia

Prognostic Value of Circulating Tumoral DNA After the First 6 Months of Treatment in Patients With Waldenström Macroglobulinemia

RECRUITING
NCT04893564Phase NACentre Hospitalier Universitaire, AmiensStarted 2022-05-16
bone marrow sampleblood sample