Evaluating the impact of novel agents on allogeneic stem cell transplant outcomes for chronic lymphocytic leukemia 

This study aimed to investigate if allogeneic stem cell transplantation (allo-SCT) was a safe and effective option for the treatment of patients with chronic lymphocytic leukemia (CLL) after treatment with novel agents (NA). 

This study concluded that this treatment option was safe and effective for patients with CLL.  

Novel agents (NAs) have improved the outcomes for patients with chronic lymphocytic leukemia (CLL). However, some patients will progress through all NAs. NAs for CLL include drugs such as ibrutinib (Imbruvica), acalabrutinib (Calquence), idelalisib (Zydelig), duvelisib (Copiktra), or venetoclax (Venclexta). 

If a patient does not respond to NAs, then allogeneic stem cell transplantation (allo-SCT) may be the next option. Allo-SCT involves transplanting cells from a healthy matched donor to the patient with CLL. It aims to replace diseased stem cells removed after previous chemotherapy or radiotherapy. However, the impact of NAs before allo-SCT in patients with CLL remains under investigation. 

This study involved 65 patients with CLL. All patients had previously been treated with one or more NAs and then underwent allo-SCT. The average follow-up was 27-29 months. 

The 24-month progression-free survival (PFS) rate was 63%. The 24-month overall survival (OS) was 81%. The 24-month non-relapse mortality (NRM – death unrelated to disease relapse) was 13%. The 24-month relapse occurrence rate was 27%. 81% of patients were estimated to be alive at 24 months.

Graft-vs-host disease (GVHD) is a complication of SCT where the transplanted cells attack the patient's body. 24% of patients developed severe GVHD 100 days after the allo-SCT.  

The number and type of NAs used prior to allo-SCT and NA use immediately before allo-SCT did not impact PFS and overall survival. Also, the use of previous NAs did not impact the safety of allo-SCT.

This study concluded that allo-SCT was a safe and effective in patients with CLL who received prior treatment with NAs. 

This study was based on data from medical records. Information might have been incomplete. Also, the number of patients in the study was quite small. Further controlled, large studies are needed to confirm these findings.