Impact of inotuzumab ozogamicin on outcome in relapsed or refractory acute B-cell lymphoblastic leukemia patients prior to allogeneic hematopoietic stem cell transplantation and risk of sinusoidal obstruction syndrome/venous occlusive disease
We evaluated 58 patients with relapsed or refractory (r/r) acute B-lymphoblastic leukemia (B-ALL; median age, 42.5 years; range, 16-69 years), treated with inotuzumab ozogamicin (INO) between 2016-2022 and who received an allogeneic hematopoietic stem cell transplantation (allo-HCT) consecutively. Forty-seven (81%) of the 58 patients were heavily pretreated receiving intensive chemotherapy +/- TKI, blinatumomab in 24 (41%) and allo-HCT at first-line in 11 (19%) patients. Complete remission (CR) rate prior to allo-HCT was 84%. Median follow-up was 30.5 months and median overall survival (OS) measured from start of INO was 11.2 months. Oneand 2-years OS rates were 50% (95%-CI, 38.4-56.1%) and 36.7% (95%-CI, 25.5-52.9%), respectively. Sinusoidal obstruction syndrome/venous occlusive disease (SOS/VOD) after allo-HCT occurred in 17 (29%) patients. Of those, 9 (53%) patients died due to SOS/VOD and multi-organ failure. Two had received >2 INO cycles (3 cycles, 5 cycles, n=1, each), all others ≤2 INO cycles prior to allo-HCT. Logistic regression analysis revealed conditioning with double alkylators (P=0.038) and allo-HCT during first-line therapy (P=0.050) as significant risk factors for SOS/VOD and in trend allo-HCT ≤ 60 days from last INO application (P=0.07), whereas number of INO cycles before allo-HCT and time between last INO application and allo-HCT were not significant. Relapse/progressive disease occurred in 20 (34%) patients. Of those, five (25%) patients are still alive, whereas 15 succumbed of their disease. Treatment with INO seems to be an effective approach with successful bridge-to-transplant. However, risk of SOS/VOD is high, necessitating continuous monitoring and recognition of SOS/VOD risk factors.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2023 |
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| Enthalten in: |
Haematologica - (2023) vom: 07. Dez. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Kayser, Sabine [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Revised 07.12.2023 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.3324/haematol.2023.284310 |
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| 245 | 1 | 0 | |a Impact of inotuzumab ozogamicin on outcome in relapsed or refractory acute B-cell lymphoblastic leukemia patients prior to allogeneic hematopoietic stem cell transplantation and risk of sinusoidal obstruction syndrome/venous occlusive disease |
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| 520 | |a We evaluated 58 patients with relapsed or refractory (r/r) acute B-lymphoblastic leukemia (B-ALL; median age, 42.5 years; range, 16-69 years), treated with inotuzumab ozogamicin (INO) between 2016-2022 and who received an allogeneic hematopoietic stem cell transplantation (allo-HCT) consecutively. Forty-seven (81%) of the 58 patients were heavily pretreated receiving intensive chemotherapy +/- TKI, blinatumomab in 24 (41%) and allo-HCT at first-line in 11 (19%) patients. Complete remission (CR) rate prior to allo-HCT was 84%. Median follow-up was 30.5 months and median overall survival (OS) measured from start of INO was 11.2 months. Oneand 2-years OS rates were 50% (95%-CI, 38.4-56.1%) and 36.7% (95%-CI, 25.5-52.9%), respectively. Sinusoidal obstruction syndrome/venous occlusive disease (SOS/VOD) after allo-HCT occurred in 17 (29%) patients. Of those, 9 (53%) patients died due to SOS/VOD and multi-organ failure. Two had received >2 INO cycles (3 cycles, 5 cycles, n=1, each), all others ≤2 INO cycles prior to allo-HCT. Logistic regression analysis revealed conditioning with double alkylators (P=0.038) and allo-HCT during first-line therapy (P=0.050) as significant risk factors for SOS/VOD and in trend allo-HCT ≤ 60 days from last INO application (P=0.07), whereas number of INO cycles before allo-HCT and time between last INO application and allo-HCT were not significant. Relapse/progressive disease occurred in 20 (34%) patients. Of those, five (25%) patients are still alive, whereas 15 succumbed of their disease. Treatment with INO seems to be an effective approach with successful bridge-to-transplant. However, risk of SOS/VOD is high, necessitating continuous monitoring and recognition of SOS/VOD risk factors | ||
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| 700 | 1 | |a Giglio, Fabio |e verfasserin |4 aut | |
| 700 | 1 | |a Bruno, Alessandro |e verfasserin |4 aut | |
| 700 | 1 | |a Webster, Jonathan |e verfasserin |4 aut | |
| 700 | 1 | |a Chiusolo, Patrizia |e verfasserin |4 aut | |
| 700 | 1 | |a Saraceni, Francesco |e verfasserin |4 aut | |
| 700 | 1 | |a Guerzoni, Selene |e verfasserin |4 aut | |
| 700 | 1 | |a Pochintesta, Lara |e verfasserin |4 aut | |
| 700 | 1 | |a Borlenghi, Erika |e verfasserin |4 aut | |
| 700 | 1 | |a Marconi, Giovanni |e verfasserin |4 aut | |
| 700 | 1 | |a Zacheo, Irene |e verfasserin |4 aut | |
| 700 | 1 | |a Cerrano, Marco |e verfasserin |4 aut | |
| 700 | 1 | |a Salutari, Prassede |e verfasserin |4 aut | |
| 700 | 1 | |a Restuccia, Francesco |e verfasserin |4 aut | |
| 700 | 1 | |a Abbenante, Mariachiara |e verfasserin |4 aut | |
| 700 | 1 | |a Levis, Mark J |e verfasserin |4 aut | |
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| 700 | 1 | |a Papayannidis, Cristina |e verfasserin |4 aut | |
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