Vol 11, No 2 (2020)
Case report
Published online: 2020-07-20

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Venetoclax monotherapy before second allogeneic hematopoietic stem cell transplantation in chronic lymphocytic leukemia

Bartosz Puła1, Joanna Mańko2, Monika Pępek34, Tomasz Stokłosa3, Kazimierz Hałaburda2, Ewa Lech-Marańda15, Iwona Hus1
Hematologia 2020;11(2):95-100.

Abstract

Chronic lymphocytic leukemia (CLL) is the most common diagnosed leukemia in adults. Its clinical course is very heterogenous and only allogeneic hematopoietic stem cell transplantation (allo-HSCT) ensures cure of this disease. Introduction of venetoclax, an antagonist of the antiapoptotic BCL-2 protein, significantly improved patient outcome. Herein we present the use of venetoclax monotherapy as a bridging therapy before second allo-HSCT in a patient with relapsed and refractory CLL.

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References

  1. Hallek M, Cheson B, Catovsky D, et al. iwCLL guidelines for diagnosis, indications for treatment, response assessment, and supportive management of CLL. Blood. 2018; 131(25): 2745–2760.
  2. Jamroziak K, Puła B, Walewski J. Current treatment of chronic lymphocytic leukemia. Curr Treat Options Oncol. 2017; 18(1): 5.
  3. Hallek M. German CLL Study Group. Prognostic factors in chronic lymphocytic leukemia. Ann Oncol. 2008; 19(Suppl 4): iv51–iv53.
  4. Cramer P, Langerbeins P, Eichhorst B, et al. Advances in first-line treatment of chronic lymphocytic leukemia: current recommendations on management and first-line treatment by the German CLL Study Group (GCLLSG). Eur J Haematol. 2016; 96(1): 9–18.
  5. Eichhorst B, Robak T, Montserrat E, et al. ESMO Guidelines Committee. Chronic lymphocytic leukaemia: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2015; 26(Suppl 5): v78–v84.
  6. Robak T, Hus I, Giannopoulos K, et al. Rekomendacje diagnostyczne i terapeutyczne dla przewlekłej białaczki limfocytowej w 2016 r – Raport Grupy Roboczej PTHiT i PALG-CLL. Acta Haematol Pol. 2016; 47(3): 169–183.
  7. Puła B, Salomon-Perzyński A, Prochorec-Sobieszek M, et al. Immunochemotherapy for Richter syndrome: current insights. Immunotargets Ther. 2019; 8: 1–14.
  8. Montserrat E, Dreger P. Treatment of chronic lymphocytic leukemia with del(17p)/TP53 mutation: allogeneic hematopoietic stem cell transplantation or BCR-signaling inhibitors? Clin Lymphoma Myeloma Leuk. 2016; 16(Suppl): S74–S81.
  9. Kharfan-Dabaja MA, Kumar A, Hamadani M, et al. Clinical practice recommendations for use of allogeneic hematopoietic cell transplantation in chronic lymphocytic leukemia on behalf of the Guidelines Committee of the American Society for Blood and Marrow Transplantation. Biol Blood Marrow Transplant. 2016; 22(12): 2117–2125.
  10. Puła B, Iskierka-Jażdżewska E, Hus M, et al. Analiza skuteczności ibrutynibu w podgrupie chorych na przewlekłą białaczkę limfocytową z delecją 17p: badanie obserwacyjne Polskiej Grupy ds. Leczenia Białaczek u Dorosłych (PALG). Acta Haematol Pol. 2017; 48(4): 330–337.
  11. Puła B, Jamroziak K, Lech-Marańda E, et al. Rola idelalizybu w leczeniu chorych na przewlekłą białaczkę limfocytową. Hematologia. 2017; 7(3): 217–230.
  12. Byrd JC, Hillmen P, O'Brien S, et al. Long-term follow-up of the RESONATE phase 3 trial of ibrutinib vs ofatumumab. Blood. 2019; 133(19): 2031–2042.
  13. O'Brien S, Jones JA, Coutre SE, et al. Ibrutinib for patients with relapsed or refractory chronic lymphocytic leukaemia with 17p deletion (RESONATE-17): a phase 2, open-label, multicentre study. Lancet Oncol. 2016; 17(10): 1409–1418.
  14. Innocenti I, Morelli F, Autore F, et al. Venetoclax in CLL patients who progress after B-cell Receptor inhibitor treatment: a retrospective multi-centre Italian experience. Br J Haematol. 2019; 187(1): e8–ee11.
  15. Furman RR, Sharman JP, Coutre SE, et al. Idelalisib and rituximab in relapsed chronic lymphocytic leukemia. N Engl J Med. 2014; 370(11): 997–1007.
  16. Del Gaizo Moore V, Brown JR, Certo M, et al. Chronic lymphocytic leukemia requires BCL2 to sequester prodeath BIM, explaining sensitivity to BCL2 antagonist ABT-737. J Clin Invest. 2007; 117(1): 112–121.
  17. Puła B, Jamroziak K. Rola wenetoklaksu w leczeniu chorych na przewlekłą białaczkę limfocytową. Hematologia. 2017; 8(1): 20–32.
  18. Roberts AW, Davids MS, Pagel JM, et al. Targeting BCL2 with venetoclax in relapsed chronic lymphocytic leukemia. N Engl J Med. 2016; 374(4): 311–322.
  19. Jones JA, Mato AR, Wierda WG, et al. Venetoclax for chronic lymphocytic leukaemia progressing after ibrutinib: an interim analysis of a multicentre, open-label, phase 2 trial. Lancet Oncol. 2018; 19(1): 65–75.
  20. Stilgenbauer S, Eichhorst B, Schetelig J, et al. Venetoclax for patients with chronic lymphocytic leukemia with 17p deletion: results from the full population of a phase II pivotal trial. J Clin Oncol. 2018; 36(19): 1973–1980.
  21. Wierda WG, Byrd JC, Davids MS, et al. Venetoclax for chronic lymphocytic leukaemia patients who progress after more than one B-cell receptor pathway inhibitor. Br J Haematol. 2019; 185(5): 961–966.
  22. Puła B, Burdacki A, Dudziński M. Znaczenie oceny minimalnej choroby resztkowej u chorych na przewlekłą białaczkę limfocytową. Hematologia. 2018; 9(2): 123–132.
  23. Kater AP, Seymour JF, Hillmen P, et al. Fixed duration of venetoclax-rituximab in relapsed/refractory chronic lymphocytic leukemia eradicates minimal residual disease and prolongs survival: post-treatment follow-up of the MURANO phase III study. J Clin Oncol. 2019; 37(4): 269–277.
  24. Fischer K, Al-Sawaf O, Bahlo J, et al. Venetoclax and obinutuzumab in patients with CLL and coexisting conditions. N Engl J Med. 2019; 380(23): 2225–2236.
  25. Seymour JF, Kipps TJ, Eichhorst B, et al. Venetoclax-rituximab in relapsed or refractory chronic lymphocytic leukemia. N Engl J Med. 2018; 378(12): 1107–1120.
  26. Döhner H, Stilgenbaues S, Benner A, et al. Genomic aberrations and survival in chronic lymphocytic leukemia. N Engl J Med. 2000; 343(26): 1910–1916.
  27. Seymour JF. Effective mitigation of tumor lysis syndrome with gradual venetoclax dose ramp, prophylaxis, and monitoring in patients with chronic lymphocytic leukemia. Ann Hematol. 2016; 95(8): 1361–1362.
  28. Stilgenbauer S, Eichhorst B, Schetelig J, et al. Venetoclax in relapsed or refractory chronic lymphocytic leukaemia with 17p deletion: a multicentre, open-label, phase 2 study. Lancet Oncol. 2016; 17(6): 768–778.
  29. Schetelig J, de Wreede LC, van Gelder M, et al. Risk factors for treatment failure after allogeneic transplantation of patients with CLL: a report from the European Society for Blood and Marrow Transplantation. Bone Marrow Transplant. 2017; 52(4): 552–560.
  30. Schetelig J, Chevallier P, Van Gelder M, et al. Remission status at transplantation and treatment history determine the survival chances of patients after allogeneic hematopoietic stem cell transplantation for chronic lymphocytic leukemia who had received pre-treatment with idelalisib: a report from the EBMT Chronic Malignancies Working Party. Blood. 2017; 130(Suppl 1): 4576.
  31. Dreger P, Michallet M, Bosman P, et al. Ibrutinib for bridging to allogeneic hematopoietic cell transplantation in patients with chronic lymphocytic leukemia or mantle cell lymphoma: a study by the EBMT Chronic Malignancies and Lymphoma Working Parties. Bone Marrow Transplant. 2019; 54(1): 44–52.
  32. Dreger P, Schetelig J, Andersen N, et al. European Research Initiative on CLL (ERIC) and the European Society for Blood and Marrow Transplantation (EBMT). Managing high-risk CLL during transition to a new treatment era: stem cell transplantation or novel agents? Blood. 2014; 124(26): 3841–3849.



Hematology in Clinical Practice