The use of ibrutinib before and after allogeneic stem cell transplantation

Massimo Martino, Anna Ferreri, Virginia Naso, Tiziana Moscato, Barbara Loteta, Massimo Gentile, Antonella Morabito, Fabio Provenzano, Michele Cimminiello, Angelo Michele Carella, Giuseppe Console, Anna Grazia Recchia

Research output: Contribution to journalReview article

Abstract

Background: FDA designated ibrutinib as a breakthrough therapy in Mantle Cell Lymphoma (MCL) and Chronic Lymphocytic Leukemia (CLL). Nevertheless, patients who progress under ibrutinib still have a poor prognosis. In this setting, allogeneic hematopoietic stem cell transplantation (allo-HSCT) could induce long-term disease control. Areas covered: The purpose of the present review is to provide information on the efficacy of ibrutinib when administered before and after allo-HSCT for CLL and MCL. Moreover, we will focus on the current role of ibrutinib for chronic GVHD. Expert opinion: Ibrutinib as bridge to allo-HSCT does not appear to affect the safety of the treatment in patients with CLL and MCL. Current evidence support further evaluation of ibrutinib for the treatment of relapsed CLL and MCL after allo-HSCT. In this setting, ibrutinib should be not only highly efficient on CLL and MCL cells but might also have the ability to enhance the activity of donor T cells. Chronic GVHD is the most common long-term complication following allo-HSCT. Results from a phase 2 clinical trial culminated in the FDA-approval of ibrutinib as second-line therapy of steroid-refractory or steroid-resistant chronic GVHD. A randomized, controlled trial in patients with chronic GVHD should be performed.

Original languageEnglish
Pages (from-to)171-180
Number of pages10
JournalExpert Opinion on Orphan Drugs
Volume7
Issue number4
DOIs
Publication statusPublished - Apr 3 2019

Keywords

  • allogeneic hematopoietic stem cell transplantation
  • chronic GVHD
  • chronic lymphocytic leukemia
  • Ibrutinib
  • mantle cell lymphoma

ASJC Scopus subject areas

  • Pharmacology, Toxicology and Pharmaceutics (miscellaneous)
  • Health Policy
  • Pharmacology (medical)

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  • Cite this

    Martino, M., Ferreri, A., Naso, V., Moscato, T., Loteta, B., Gentile, M., Morabito, A., Provenzano, F., Cimminiello, M., Carella, A. M., Console, G., & Recchia, A. G. (2019). The use of ibrutinib before and after allogeneic stem cell transplantation. Expert Opinion on Orphan Drugs, 7(4), 171-180. https://doi.org/10.1080/21678707.2019.1609938