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

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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.

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Change history

  • 27 November 2019

    In the original publication, Paolo Corradini’s affiliation was incorrect. This has been updated in the PDF and HTML of the original article.

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MM, PD, MS, and JS designed the study, LK and JH collected the data, MS performed statistical analysis, MM, PD, and MS wrote the paper, All other co-authors reviewed, commented and approved the final version of the paper.

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Correspondence to Mauricette Michallet.

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Michallet, M., Dreger, P., Sobh, M. et al. Ibrutinib as a salvage therapy after allogeneic HCT for chronic lymphocytic leukemia. Bone Marrow Transplant 55, 884–890 (2020). https://doi.org/10.1038/s41409-019-0742-7

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