TY - JOUR
T1 - Ibrutinib as a salvage therapy after allogeneic HCT for chronic lymphocytic leukemia
AU - Michallet, Mauricette
AU - Dreger, Peter
AU - Sobh, Mohamad
AU - Koster, Linda
AU - Hoek, Jennifer
AU - Boumendil, Ariane
AU - Scheid, Christof
AU - Fox, Christopher P
AU - Wulf, Gerald
AU - Krüger, William
AU - van Gelder, Michel
AU - Corradini, Paolo
AU - Russo, Domenico
AU - Passweg, Jakob
AU - Schoemans, Hélène
AU - Bethge, Wolfgang
AU - Schaap, Nicolaas
AU - Cornelissen, Jan
AU - Browne, Paul
AU - Durakovic, Nadira
AU - Muller, Lutz
AU - Montoto, Silvia
AU - Kroger, Nicolaus
AU - Schetelig, Johannes
AU - French Cooperative Group for CLL, SFGM-TC, and the EBMT Chronic Malignancy and Lymphoma Working Parties
N1 - Publisher Copyright:
© 2019, The Author(s), under exclusive licence to Springer Nature Limited.
PY - 2020/5
Y1 - 2020/5
N2 - 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.
AB - 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.
KW - STEM-CELL TRANSPLANTATION
KW - HIGH-RISK CLL
KW - TARGETING BTK
KW - T-CELLS
KW - OUTCOMES
KW - FAILURE
KW - DISEASE
U2 - 10.1038/s41409-019-0742-7
DO - 10.1038/s41409-019-0742-7
M3 - Article
C2 - 31700137
SN - 0268-3369
VL - 55
SP - 884
EP - 890
JO - Bone Marrow Transplantation
JF - Bone Marrow Transplantation
IS - 5
ER -