2014
DOI: 10.1182/blood-2014-07-586826
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Managing high-risk CLL during transition to a new treatment era: stem cell transplantation or novel agents?

Abstract: Allogeneic hematopoietic stem cell transplantation (HSCT) has been considered as the treatment of choice for patients with high-risk chronic lymphocytic leukemia (HR-CLL; ie, refractory to purine analogs, short response [<24 months] to chemoimmunotherapy, and/or presence of del[17p]/TP53 mutations). Currently, treatment algorithms for HR-CLL are being challenged by the introduction of novel classes of drugs. Among them, BCR signal inhibitors (BCRi) and B-cell lymphoma 2 antagonists (BCL2a) appear particular… Show more

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Cited by 182 publications
(117 citation statements)
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“…42 Overall, these drugs, which are to be taken until disease progression, seem well tolerated, but a substantial number of patients discontinues because of sideeffects (4% at a median follow-up of 9.4 months and 16% at 20.9 months for ibrutinib, 43,44 9% for idelalisib at a median followup of only 3.8 months 45 ). Patients that discontinue treatment have a short survival, 46 which illustrates that durable disease control had not been provided.…”
Section: Discussionmentioning
confidence: 99%
“…42 Overall, these drugs, which are to be taken until disease progression, seem well tolerated, but a substantial number of patients discontinues because of sideeffects (4% at a median follow-up of 9.4 months and 16% at 20.9 months for ibrutinib, 43,44 9% for idelalisib at a median followup of only 3.8 months 45 ). Patients that discontinue treatment have a short survival, 46 which illustrates that durable disease control had not been provided.…”
Section: Discussionmentioning
confidence: 99%
“…1 Despite the curative potential of the method, up to 50% of patients may experience relapse even after alloSCT. 2 Treatment of this group of patients represents a challenge. In 2014 ibrutinib, a first-in-class small molecule and irreversible inhibitor of Bruton's tyrosine kinase (BTK), was approved for the treatment of patients with CLL.…”
Section: Introductionmentioning
confidence: 99%
“…2,3 Those facts led investigators from the European Society for Bone Marrow Transplantation (EBMT) and the European Research Initiative on CLL to refine EBMT prior recommendations and to restrict alloHCT to selected patients previously treated with one of these agents. 4 The question we face now is: should targeted therapies replace alloHCT entirely?…”
mentioning
confidence: 99%