In a nutshell
This study investigated the safety and effectiveness of alloHCT (allogeneic hematopoietic stem cell transplantation) in patients with mantle cell lymphoma (MCL) pre-treated with ibrutinib (Imbruvica). This study concluded that ibrutinib does not affect the safety of alloHCT.
Ibrutinib has become the standard of care for patients with relapsed or refractory (did not respond to treatment) mantle cell lymphoma (MCL). This treatment, however, does not cure MCL. Many patients progress despite treatment. Patients who progress generally undergo alloHCT (stem cell transplant using donor stem cells). Whether pre-transplant ibrutinib affects the safety or effectiveness of alloHCT in MCL remains under investigation.
Methods & findings
This study included information on 70 patients with MCL (31.4%) or chronic lymphocytic leukemia (68.5%). All patients received ibrutinib treatment before alloHCT. The average follow-up period was 13 months post-transplant.
At the time of transplant, 73% of patients responded to ibrutinib treatment. 41% of MCL patients achieved a complete response (CR; complete disappearance of all signs of cancer). 9% of MCL patients experienced progressive disease.
98.6% of patients had successful engraftment (transplanted stem cells enter the bone marrow and start making new blood cells). 47.1% of patients had grade 2 – 4 acute GVHD (when transplanted cells attack healthy cells). At follow-up, 54% of patients had chronic GVHD. Of these, 23% experienced complete symptom resolution.
After 12 months, the overall survival (time from transplant to death from any cause) was 86% for MCL patients. 76% of patients were progression-free. 19% of patients relapsed. The non-relapse mortality (time from transplant to death not due to relapse or progression) rate was 5%.
The bottom line
This study concluded that ibrutinib does not affect the safety of alloHCT. The authors suggest that ibrutinib can improve the feasibility and effectiveness of alloHCT for relapsed or refractory MCL patients.
Published By :
Bone Marrow Transplantation
May 04, 2018
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