Efficacy of ibrutinib in late relapse chronic lymphocytic leukemia allogeneic hematopoietic stem cell transplantantion

The introduction of new drugs such as ibrutinib (IBR), idelalisib, and venetoclax has changed the standard treatment of the chronic lymphocytic leukemia (CLL),1-3 but the allogeneic stem cell transplantation (hematopoietic stem cell transplantation, HSCT) remains a gold-standard for relapse-refractory fit young patients who progress after Bruton Kinase Inhibitors or anti-Bcl2.4, 5 HSCT is the only curative treatment, with also chimeric antigen receptor T cell (CAR-T), that has a potential long-term disease free survival control, because of still limited follow-up, in high risk or refractory CLL patients.4 IBR is safe and effective in naive or relapsed/refractory CLL patients also in high risk patients (17p deletion or TP53 mutation).6, 7 While there are many published data describing the use of IBR in frontline or relapsed/refractory patients6; the role and the timing of IBR in relapsed CLL patients, expecially during long term follow-up, post allogeneic HSCT is still unclear.