TY - JOUR
T1 - Current state of hematopoietic cell transplantation in CLL as smart therapies emerge
AU - Kharfan-Dabaja, Mohamed A.
AU - El-Asmar, Jessica
AU - Awan, Farrukh T.
AU - Hamadani, Mehdi
AU - Ayala, Ernesto
N1 - Funding Information:
Funding: F.T.A is supported by a CDA from the Lymphoma Research Foundation .
Publisher Copyright:
© 2016 Elsevier Ltd
PY - 2016/3/1
Y1 - 2016/3/1
N2 - Novel therapies targeting various kinases downstream of the B-cell receptor have emerged along with monoclonal antibodies and BCL-2 antagonists, and are changing the therapeutic landscape of chronic lymphocytic leukemia. However, cure remains unattainable unless eligible patients are offered an allogeneic hematopoietic cell transplant. Access to allogeneic hematopoietic cell transplantation has expanded considerably with availability of reduced intensity conditioning regimens which is capable offering durable remissions even in poor-risk disease. Encouraging data from ibrutinib and venetoclax in Del17p is challenging the notion of disease eradication as the ultimate therapeutic goal to a new concept of merely disease control. By favoring the non-transplant approach, patients should be aware that there are no established salvage therapies, yet, to rescue disease progression after ibrutinib. When disease eradication is the desirable approach, a reduced intensity conditioning allogeneic hematopoietic cell transplant is the preferred choice at this time.
AB - Novel therapies targeting various kinases downstream of the B-cell receptor have emerged along with monoclonal antibodies and BCL-2 antagonists, and are changing the therapeutic landscape of chronic lymphocytic leukemia. However, cure remains unattainable unless eligible patients are offered an allogeneic hematopoietic cell transplant. Access to allogeneic hematopoietic cell transplantation has expanded considerably with availability of reduced intensity conditioning regimens which is capable offering durable remissions even in poor-risk disease. Encouraging data from ibrutinib and venetoclax in Del17p is challenging the notion of disease eradication as the ultimate therapeutic goal to a new concept of merely disease control. By favoring the non-transplant approach, patients should be aware that there are no established salvage therapies, yet, to rescue disease progression after ibrutinib. When disease eradication is the desirable approach, a reduced intensity conditioning allogeneic hematopoietic cell transplant is the preferred choice at this time.
KW - Allogeneic hematopoietic cell transplantation
KW - B-cell receptor inhibitors
KW - Reduced intensity conditioning
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U2 - 10.1016/j.beha.2016.08.001
DO - 10.1016/j.beha.2016.08.001
M3 - Review article
C2 - 27742072
AN - SCOPUS:84992187395
SN - 1521-6926
VL - 29
SP - 54
EP - 66
JO - Best Practice and Research: Clinical Haematology
JF - Best Practice and Research: Clinical Haematology
IS - 1
ER -