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

Bone Marrow Transplantation volume 55, pages 884–890 (2020)Cite this article

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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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Author information

Authors and Affiliations

  1. Hematology Department, Centre Léon Bérard, Lyon, France

    Mauricette Michallet & Mohamad Sobh

  2. Internal Medicine V, University of Heidelberg, Heidelberg, Germany

    Peter Dreger

  3. EBMT Data Office, Leiden, Netherlands

    Linda Koster & Jennifer Hoek

  4. EBMT, EBMT Lymphoma Working Party, Paris, France

    Ariane Boumendil

  5. Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany

    Christof Scheid

  6. Department of Clinical Haematology, Nottingham University Hospitals NHS Trust, Nottingham, UK

    Christopher P. Fox

  7. Department of Hematology and Oncology, Universitaetsklinikum Goettingen, Goettingen, Germany

    Gerald Wulf

  8. Department of Hematology, Universitaetsmedizin Greifswald, Greifswald, Germany

    William Krüger

  9. Department of Internal Medicine/Hematology, University Medical Center, Maastricht, Netherlands

    Michel van Gelder

  10. Hematology Division, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, University of Milano, Milan, Italy

    Paolo Corradini

  11. Unit of Blood Diseases and Stem Cell Transplantation, Department of Clinical and Experimental Sciences, Brescia University, ASST Spedali Civili Brescia, Brescia, Italy

    Domenico Russo

  12. Department of Hematology, University Hospital, Basel, Switzerland

    Jakob Passweg

  13. Department of Hematology, University Hospital Leuven and KU Leuven, Leuven, Belgium

    Hélène Schoemans

  14. Department of Hematology, Eberhard Karls University Tuebingen, Tuebingen, Germany

    Wolfgang Bethge

  15. Department of Hematology, Radboud University Medical Centre, Nijmegen, Netherlands

    Nicolaas Schaap

  16. Department of Hematology, Erasmus MC Cancer Institute, Rotterdam, Netherlands

    Jan Cornelissen

  17. Hope Directorate, St. James’s Hospital, Dublin, Ireland

    Paul Browne

  18. Department of Hematology, Clinical Hospital Center Zagreb, Zagreb, Croatia

    Nadira Durakovic

  19. Department of Hematology, Martin-Luther-Univeristy, Halle, Germany

    Lutz Muller

  20. Department of Haemato-oncology, St. Bartholomew’s Hospital, Barts Health NHS Trust, London, UK

    Silvia Montoto

  21. University Hospital Eppendorf, Hamburg, Germany

    Nicolaus Kroger

  22. Department of Hematology, University Hospital Dresden, Dresden, Germany

    Johannes Schetelig

Authors
  1. Mauricette Michallet
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  18. Jan Cornelissen
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  24. Johannes Schetelig
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Consortia

on behalf of the French Cooperative Group for CLL, SFGM-TC, and the EBMT Chronic Malignancy and Lymphoma Working Parties

Contributions

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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