Ibrutinib as a salvage therapy after allogeneic HCT for chronic lymphocytic leukemia

Mauricette Michallet*, Peter Dreger, Mohamad Sobh, Linda Koster, Jennifer Hoek, Ariane Boumendil, Christof Scheid, Christopher P Fox, Gerald Wulf, William Krüger, Michel van Gelder, Paolo Corradini, Domenico Russo, Jakob Passweg, Hélène Schoemans, Wolfgang Bethge, Nicolaas Schaap, Jan Cornelissen, Paul Browne, Nadira DurakovicLutz Muller, Silvia Montoto, Nicolaus Kroger, Johannes Schetelig, French Cooperative Group for CLL, SFGM-TC, and the EBMT Chronic Malignancy and Lymphoma Working Parties

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

9 Citations (Web of Science)

Abstract

The purpose of our study is to provide information on safety and efficacy of ibrutinib as salvage treatment after allo-HSCT for CLL. A total of 56 patients were included, 36 (64%) males; median age at transplantation was 48 years (range: 35-64) and the median number of treatment lines prior to transplantation was 3 (1-10). The median time between allo-HSCT and Ibrutinib was 30 months (range: 1-140). Overall, 40 (71%) patients responded to Ibrutinib; 23 (41%) PR, and 17 (30%) CR. At time of ibrutinib initiation, ten patients had active chronic GVHD that resolved under Ibrutinib, whilst a single patient developed limited de novo chronic GVHD on Ibrutinib. Fourteen patients discontinued ibrutinib, four because of toxicity and ten because of disease progression. Overall, 14 patients progressed (median PFS = 24 months) among them 10 died. Two-year OS and PFS probabilities were 72% (95% CI: 52-84) and 50% (95% CI: 32-66), respectively. Patients with late relapse after allo-HSCT (≥24 months) had a better PFS after ibrutinib. Our study shows that ibrutinib can be safely administered for CLL relapse after allo-HSCT, with comparable efficacy to non-transplanted patients with high-risk disease.

Original languageEnglish
Pages (from-to)884-890
Number of pages7
JournalBone Marrow Transplantation
Volume55
Issue number5
Early online date7 Nov 2019
DOIs
Publication statusPublished - May 2020

Keywords

  • STEM-CELL TRANSPLANTATION
  • HIGH-RISK CLL
  • TARGETING BTK
  • T-CELLS
  • OUTCOMES
  • FAILURE
  • DISEASE

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