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Transplant After Inotuzumab Ozogamicin Therapy Improves Survival in Relapsed/Refractory ALL
A long-term survival benefit was observed among patients with relapsed/refractory acute lymphoblastic leukemia (ALL) who received no prior HSCT and proceeded to transplant directly after remission with inotuzumab ozogamicin, according to a study published in Biology of Blood and Marrow Transplantation (2019 Apr 27. Epub ahead of print).
Achieving complete remission of ALL before undergoing HSCT correlates with better outcomes posttransplant outcomes, explained David I. Marks, MB, BS, PhD, FRACP, FRCPath, University Hospitals Bristol NHS Trust, United Kingdom, and colleagues.
“Inotuzumab ozogamicin…has shown significantly higher rates of remission, minimal residual disease negativity, and HSCT versus standard chemotherapy in treating relapsed/refractory…ALL,” they noted.
This information led Dr Marks and colleagues to investigate the role of previous transplant and direct advancement to HSCT after remission with inotuzumab ozogamicin in influencing posttransplant survival in patients with relapsed/refractory ALL.
The study analyzed 101 patients treated with Inotuzumab ozogamicin who proceeded to allogeneic HSCT; 63% received inotuzumab ozogamicin as first salvage therapy and 85% had no prior HSCT.
The median posttransplant overall survival (OS) was 9.2 months, with a 2-year survival probability of 41%. Among patients who had not undergone HSCT, median posttransplant OS was 11.8 months, with a 2-year survival probability of 46%.
A total of 28 patients had disease relapse and needed additional treatment before HSCT. Among 73 patients who proceeded directly to first HSCT after remission with no additional treatment, median posttransplant OS was not reached, with a 2-year survival probability of 51%.
“In patients with R/R [relapsed/refractory] ALL…[inotuzumab ozogamicin] followed by allogeneic HSCT provided optimal long-term survival benefit among those with no previous HSCT who went directly to transplant after remission,” Dr Marks et al concluded.—Janelle Bradley
