Clinical outcome of allogeneic stem cell transplantation in patients with B-cell lymphoid malignancies following treatment with targeted small molecule inhibitors

Leuk Lymphoma. 2022 Apr;63(4):885-893. doi: 10.1080/10428194.2022.2043302. Epub 2022 Feb 27.

Abstract

We aimed to study the risks of graft-versus-host disease (GVHD), non-relapse mortality (NRM) and survival outcomes of allogeneic stem cell transplantation (alloSCT) in patients with chronic lymphocytic leukemia (n = 17), Richter's syndrome (n = 14), or lymphoma (n = 18) after small molecule inhibitors (SMIs). Patients had a median of 4 prior therapies, including ibrutinib (n = 46; 94%), venetoclax (n = 19; 39%), and idelalisib (n = 6; 12%). Twenty-one (43%) had >1 SMI. P53 mutation was detected in 58% of patients. The 3-year overall and progression-free survival rates were 68% and 59%, respectively. The rates of grade II-IV and III-IV acute GVHD were 33% and 7%. The 1-year rates of chronic GVHD, NRM and relapse were 19%, 10% and 21%, respectively. Results were comparable to a historical control of patients who received alloSCT without a prior exposure to SMI. We conclude that a prior use of SMI does not impair the outcomes after alloSCT.

Keywords: AllosSCT; b-cell malignancies; small molecule inhibitors.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Graft vs Host Disease* / diagnosis
  • Graft vs Host Disease* / etiology
  • Hematopoietic Stem Cell Transplantation* / methods
  • Humans
  • Leukemia, Lymphocytic, Chronic, B-Cell* / diagnosis
  • Leukemia, Lymphocytic, Chronic, B-Cell* / drug therapy
  • Lymphoma, Large B-Cell, Diffuse* / etiology
  • Recurrence
  • Stem Cell Transplantation / adverse effects
  • Transplantation Conditioning / methods
  • Treatment Outcome