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Ibrutinib for bridging to allogeneic hematopoietic cell transplantation in patients with chronic lymphocytic leukemia or mantle cell lymphoma: a study by the EBMT Chronic Malignancies and Lymphoma Working Parties.
- Source :
-
Bone marrow transplantation [Bone Marrow Transplant] 2019 Jan; Vol. 54 (1), pp. 44-52. Date of Electronic Publication: 2018 May 04. - Publication Year :
- 2019
-
Abstract
- The aim of this retrospective study was to investigate the safety and efficacy of allogeneic hematopoietic cell transplantation (alloHCT) in patients pre-treated with ibrutinib. Eligible were patients aged >18 years allotransplanted for chronic lymphocytic leukemia (CLL) or mantle cell lymphoma (MCL) after prior exposure to ibrutinib who were registered with the EBMT registry. Seventy patients (CLL 48, MCL 22) were included. At the time of alloHCT, 73% of the patients were ibrutinib responsive. All patients except one engrafted, and acute GVHD grade 2-4 (3-4) was observed in 49% (12%) of 68 evaluable patients. The cumulative incidence of chronic GVHD was 54% 1 year after transplant. In the CLL group, 12-month non-relapse mortality, relapse incidence (RI), progression-free survival (PFS), and overall survival (OS) were 10, 30, 60, and 72%, respectively, and in the MCL group 5, 19, 76, and 86%, respectively. Pre-transplant ibrutinib failure and poor performance status predicted inferior RI, PFS and OS in the CLL group. In conclusion, ibrutinib does not affect the safety of a subsequent alloHCT. While the relatively high post-transplant relapse risk in ibrutinib-exposed patients with CLL deserves further study, in patients with MCL consolidating disease responses to ibrutinib with alloHCT seems to be a promising option.
- Subjects :
- Adenine analogs & derivatives
Adult
Aged
Allografts
Disease-Free Survival
Female
Humans
Male
Middle Aged
Piperidines
Survival Rate
Graft vs Host Disease mortality
Graft vs Host Disease prevention & control
Hematopoietic Stem Cell Transplantation
Leukemia, Lymphocytic, Chronic, B-Cell mortality
Leukemia, Lymphocytic, Chronic, B-Cell therapy
Lymphoma, Mantle-Cell mortality
Lymphoma, Mantle-Cell therapy
Pyrazoles administration & dosage
Pyrimidines administration & dosage
Subjects
Details
- Language :
- English
- ISSN :
- 1476-5365
- Volume :
- 54
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Bone marrow transplantation
- Publication Type :
- Academic Journal
- Accession number :
- 29728701
- Full Text :
- https://doi.org/10.1038/s41409-018-0207-4