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

• Verfasst von: Kayser, Sabine [VerfasserIn]
• Verfasst von: Sartor, Chiara [VerfasserIn]
• Verfasst von: Giglio, Fabio [VerfasserIn]
• Verfasst von: Bruno, Alessandro [VerfasserIn]
• Verfasst von: Webster, Jonathan [VerfasserIn]
• Verfasst von: Chiusolo, Patrizia [VerfasserIn]
• Verfasst von: Saraceni, Francesco [VerfasserIn]
• Verfasst von: Guerzoni, Selene [VerfasserIn]
• Verfasst von: Pochintesta, Lara [VerfasserIn]
• Verfasst von: Borlenghi, Erika [VerfasserIn]
• Verfasst von: Marconi, Giovanni [VerfasserIn]
• Verfasst von: Zacheo, Irene [VerfasserIn]
• Verfasst von: Cerrano, Marco [VerfasserIn]
• Verfasst von: Salutari, Prassede [VerfasserIn]
• Verfasst von: Restuccia, Francesco [VerfasserIn]
• Verfasst von: Abbenante, Mariachiara [VerfasserIn]
• Verfasst von: Levis, Mark J. [VerfasserIn]
• Verfasst von: Schlenk, Richard Friedrich [VerfasserIn]
• Verfasst von: Papayannidis, Cristina [VerfasserIn]
• Titel: 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
• Verf.angabe: Sabine Kayser, Chiara Sartor, Fabio Giglio, Alessandro Bruno, Jonathan Webster, Patrizia Chiusolo, Francesco Saraceni, Selene Guerzoni, Lara Pochintesta, Erika Borlenghi, Giovanni Marconi, Irene Zacheo, Marco Cerrano, Prassede Salutari, Francesco Restuccia, Mariachiara Abbenante, Mark J. Levis, Richard F. Schlenk and Cristina Papayannidis
• E-Jahr: 2024
• Jahr: May, 2024
• Umfang: 8 S.
• Illustrationen: Illustrationen
• Fussnoten: Online veröffentlicht: 7. Dezember 2023 ; Gesehen am 12.12.2024
• Titel Quelle: Enthalten in: Haematologica
• Ort Quelle: Pavia : Ferrata Storti Foundation, 2014
• Jahr Quelle: 2024
• Band/Heft Quelle: 109(2024), 5, Seite 1385-1392
• ISSN Quelle: 1592-8721
• DOI: doi:10.3324/haematol.2023.284310
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1912138026

Abstract

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 +/- tyrosine kinase inhibitor, blinatumomab in 24 (41%) and allo-HCT at first-line in 11 (19%) patients. Complete remission 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. One- and 2-year OS rates were 50% (95% confidence interval [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, nine (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.