Idelalisib treatment prior to allogeneic stem cell transplantation for patients with chronic lymphocytic leukemia: a report from the EBMT chronic malignancies working party - Inserm - Institut national de la santé et de la recherche médicale Access content directly
Journal Articles Bone Marrow Transplantation Year : 2020

Idelalisib treatment prior to allogeneic stem cell transplantation for patients with chronic lymphocytic leukemia: a report from the EBMT chronic malignancies working party

1 University Hospital Carl Gustav Carus [Dresden, Germany]
2 DKMS
3 CHU Nantes - Centre hospitalier universitaire de Nantes
4 MUMC - Maastricht University Medical Centre
5 EBMT Data Office Leiden [Leiden, TheNetherlands]
6 Hôpital Necker - Enfants Malades [AP-HP]
7 Imagine - U1163 - Imagine - Institut des maladies génétiques (IHU)
8 UCLH - University College London Hospitals
9 HD - Hope Directorate [Dublin, Ireland]
10 CHU Bordeaux
11 UniBs - Università degli Studi di Brescia = University of Brescia
12 AP-HP - Hopital Saint-Louis [AP-HP]
13 CRESIB - Barcelona Centre for International Health Research, Hospital Clinic
14 Hôpital JeanMinjoz
15 CHU Caen
16 NU - Normandie Université
17 CHU Henri Mondor [Créteil]
18 AöR - University Hospital Essen
19 CHU Pitié-Salpêtrière [AP-HP]
20 SU - Sorbonne Université
21 University Hospitals Birmingham [Birmingham, Royaume-Uni]
22 DKD HELIOS Medical Center - DKD Helios Klinik Wiesbaden [Wiesbaden, Germany]
23 University Hospital Brno
24 Service des maladies du sang [Angers]
25 Saarland University [Saarbrücken]
26 GPMCND - Génomique et Médecine Personnalisée du Cancer et des Maladies Neuropsychiatriques
27 CLCC Henri Becquerel - Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen
28 LUMC - Leiden University Medical Center
29 CHU Clermont-Ferrand
30 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
31 LIRIC - Lille Inflammation Research International Center - U 995
32 University Hospital Hamburg-Eppendorf
33 Universität Heidelberg [Heidelberg] = Heidelberg University
Noel Milpied
  • Function : Author
Gerard Socié
Eric Deconinck
Henning Baldauf
  • Function : Author
Olivier Tournilhac
Nicolaus Kröger

Abstract

No studies have been reported so far on bridging treatment with idelalisib for patients with chronic lymphocytic leukemia (CLL) prior to allogeneic hematopoietic cell transplantation (alloHCT). To study potential carry-over effects of idelalisib and to assess the impact of pathway-inhibitor (PI) failure we performed a retrospective EBMT registry-based study. Patients with CLL who had a history of idelalisib treatment and received a first alloHCT between 2015 and 2017 were eligible. Data on 72 patients (median age 58 years) were analyzed. Forty percent of patients had TP53 mut/del CLL and 64% had failed on at least one PI. No primary graft failure occurred. Cumulative incidences of acute GVHD°II-IV and chronic GVHD were 51% and 39%, respectively. Estimates for 2-year overall survival (OS), progression-free survival (PFS), and cumulative incidences of relapse/progression (CIR) and non-relapse mortality NRM were 59%, 44%, 25%, and 31%. In univariate analysis, drug sensitivity was a strong risk factor. For patients who had failed neither PI treatment nor chemoimmunotherapy (CIT) the corresponding 2-year estimates were 73%, 65%, 15%, and 20%, respectively. In conclusion, idelalisib may be considered as an option for bridging therapy prior to alloHCT. Owing to the high risk for acute GVHD intensified clinical monitoring is warranted.

Domains

Hematology
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Dates and versions

inserm-03549845 , version 1 (31-01-2022)

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Johannes Schetelig, Patrice Chevallier, Michel van Gelder, Jennifer Hoek, Olivier Hermine, et al.. Idelalisib treatment prior to allogeneic stem cell transplantation for patients with chronic lymphocytic leukemia: a report from the EBMT chronic malignancies working party. Bone Marrow Transplantation, 2020, 56 (3), pp.605 - 613. ⟨10.1038/s41409-020-01069-w⟩. ⟨inserm-03549845⟩
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