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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. Fo...

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Main Authors: Kayser, Sabine (Author) , Sartor, Chiara (Author) , Giglio, Fabio (Author) , Bruno, Alessandro (Author) , Webster, Jonathan (Author) , Chiusolo, Patrizia (Author) , Saraceni, Francesco (Author) , Guerzoni, Selene (Author) , Pochintesta, Lara (Author) , Borlenghi, Erika (Author) , Marconi, Giovanni (Author) , Zacheo, Irene (Author) , Cerrano, Marco (Author) , Salutari, Prassede (Author) , Restuccia, Francesco (Author) , Abbenante, Mariachiara (Author) , Levis, Mark J. (Author) , Schlenk, Richard Friedrich (Author) , Papayannidis, Cristina (Author)
Format: Article (Journal)
Language:English
Published: May, 2024
In: Haematologica
Year: 2024, Volume: 109, Issue: 5, Pages: 1385-1392
ISSN:1592-8721
DOI:10.3324/haematol.2023.284310
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.3324/haematol.2023.284310
Verlag, lizenzpflichtig, Volltext: https://haematologica.org/article/view/haematol.2023.284310
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Author Notes: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
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Summary: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.
Item Description:Online veröffentlicht: 7. Dezember 2023
Gesehen am 12.12.2024
Physical Description:Online Resource
ISSN:1592-8721
DOI:10.3324/haematol.2023.284310

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