Ibrutinib, a BTK inhibitor commonly used to treat lymphoma types like chronic lymphocytic leukemia (CLL) and mantle cell lymphoma, has been approved by the United States Food and Drug Administration (FDA) for treatment of adults with chronic graft versus host disease (cGVHD).
GVHD can occur following a stem cell or bone marrow transplant from a related or unrelated donor, also known as an allogeneic transplant. When the immune cells from the graft (donor) are infused into the body of the host (patient), they may recognize the host’s native cells as foreign and try to destroy them. While some cases of GVHD are life threatening, chronic cases tend to generate to more mild symptoms, like dry eyes and mouth, fatigue, and muscle weakness and stiffness.
Ibrutinib becomes the first FDA-approved treatment of cGVHD following clinical trials demonstrating durable safety and effectiveness in patients whose symptoms were resistant to prior corticosteroid treatment administered for immune system suppression.
In an interview with the Lymphoma Research Foundation (LRF), Dr. Peter Martin discusses mantle cell lymphoma (MCL), treatment options including transplantation, and what advice he would give to people who are newly diagnosed with MCL.
Debate exists among researchers on whether or when stem cell transplantation should be used in the treatment of MCL. Why do you think this is so?
“Some people feel that stem cell transplantation is likely to make a patient live longer and others feel that a long remission duration following a stem cell transplant means there are fewer lymphoma-related side effects, and everybody likes that idea.
On the other hand, autologous stem cell transplantation doesn’t cure MCL. There are limited data that suggest that it may allow people to live longer, and many patients may experience significant side effects but not have a very durable remission and a longer life. So that’s a very subjective sort of decision based on less than perfect evidence.
It’s our job as lymphoma doctors to help patients understand the potential benefits and the potential negative side effects to all treatment options so they can select a treatment that is best for them. There’s no right or wrong treatment option in many cases and it’s a matter of choosing the option that makes the most sense for that person at that point in time.”
The full interview can be read on the LRF’s website.
As part of an expert panel hosted by OncLive, Dr. Richard Furman discussed the role of transplantation in patients with high-risk CLL.
Previous parts of the discussion can be found here.