Conference Correspondent

ASH 2016 - Chronic Lymphocytic Leukemia

The most important positive prognostic factor for 2-year nonrelapse mortality in chronic lymphocytic leukemia (CLL) patients following allogeneic hematopoietic stem-cell transplantation (alloSCT) is the donor HLA match. AlloSCT still remains a valid option for younger, high cytogenetic risk, refractory/relapsed CLL patients with an HLA-allele well-matched donor.
Ibrutinib enhances intrinsic JCAR017 activity and may improve outcomes in chronic lymphocytic leukemia patients treated with anti-CD19 CAR T therapy, irrespective of Bruton tyrosine kinase mutational status.
Treatment of elderly and/or unfit chronic lymphocytic leukemia (CLL) patients with chlorambucil plus rituximab is associated with low toxicity, a high overall response rate and durable progression-free survival, especially in patients with a mutated IGHV profile and not carrying del17p and del11q. In this low-risk subset of unfit patients, this combination could represent the optimal therapeutic option taking into consideration safety, efficacy, and cost.
In a single-center study, atrial fibrillation events in patients being treated with ibrutinib were generally manageable and, in the majority of cases, did not result in drug discontinuation.
Ibrutinib plus fludarabine/cyclophosphamide/rituximab (FCR) induces deep responses in previously untreated young patients with chronic lymphocytic leukemia (CLL), with 39% of evaluable patients achieving complete response with bone marrow minimal residual disease negativity (BM MRD-neg) and 89% achieving BM MRD-neg, significantly higher than the 20% rate seen historically with FCR alone.
In pooled data from 3 randomized studies, the benefit of ibrutinib on progression-free and overall survival is most marked in patients with CLL/SLL with del11q, which is not the case with ofatumumab, chlorambucil, or bendamustine/rituximab.
Progression-free survival for treatment-naive ibrutinib-treated chronic lymphocytic leukemia/small lymphocytic leukemia (CLL/SLL) patients was similar regardless of age subgroup, whereas it was shorter for chlorambucil-treated patients aged ≥75 years compared with those aged 65 to
The combination of nivolumab and ibrutinib has activity in patients with relapsed, refractory chronic lymphocytic leukemia (CLL) and Richter transformation.
With a median time on study of 28.6 months, ibrutinib demonstrated an 88% reduction in risk of progression or death in an elderly chronic lymphocytic leukemia/small lymphocytic leukemia patient population, with treatment-limiting adverse events decreasing in frequency with longer follow-up.
After 5 years of follow-up, single-agent ibrutinib continues to show durable responses in patients with treatment-naive or relapsed/refractory chronic lymphocytic leukemia/small lymphocytic leukemia, including those with del17p, del11q, or unmutated IGVH.
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