Allograft

[sue6741]

Just wanted to know if anyone knew anything about Allograft. My husband has just finished 2 yrs on ventaclax, all blood's good, and we expected to just go away and go back for blood's until maybe time for a different treatment, but was told they would like us to have a chat to a specialist about allograft for the future(just a chat) this threw me. Any thoughts. In the ten yrs he's had CLL He's had FCR, IBRUTINIB AND VENTACLAX. Thanks

[lankisterguy Volunteer]

Hi sue6741,

I suspect this is merely a "MedSpeak" synonym for SCT (Stem Cell Transplant) or BMT (Bone Marrow Transplant ) from a matched / unrelated donor.

As contrasted with an autograph (e.g. CAR-T)

cancer.gov/publications/dic...

"(A-loh-graft) The transplant of an organ, tissue, or cells from one individual to another individual of the same species who is not an identical twin."

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You can find more info from these 91 past postings: healthunlocked.com/cllsuppo...

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Len

[sue6741 in reply to lankisterguy]

Thank you for your reply, will look at links.

[MrMidnight]

My haematologist (in New Zealand) suggested I should start considering a stem-cell transplant after my bloods had been normal for a year on Venetoclax. I had already had five years on Zanubrutinib and he said he had nothing else to give me once Venetoclax failed.

I decided I'd continue with Venetoclax in the hope that it would work for several more years. So far — three and a half years in — I'm pleased with my decision. But it's always a gamble.

[sue6741 in reply to MrMidnight]

Thank you for your reply, they did not suggest staying on ventaclax, he's only been off the tablets 2 wks, so will see what chat about Allograft says.

[MrMidnight in reply to sue6741]

I should have added that I'm 17p deleted, and although my bone marrow results a year ago showed deep remission (20 CLL cells in a million) it is not recommended for 17p patients to stop taking Venetoclax.

Good luck with your chat.

[sue6741 in reply to MrMidnight]

His diagnosis says deletion 13q unmutated IGHV 3-21 gene and stereotyped CDR3. As I sad don't understand much but try.

[Skyshark]

AlloSTC is only recommended for under 65's, it becomes higher risk over 65. Time may be of the essence.

He is running out of approved treatments in the UK. He is approaching the box at the bottom right.

clatterbridgecc.nhs.uk/appl...

The makers of Lisocabtagene maraleucel are no longer pursuing European marketing approval. This is a CAR-T therapy.

nice.org.uk/guidance/indeve...

Pirtobrutinib a non-covalent BTKi drug may get approved for UK NHS, possibly late this year or early next year. For pre-treated patients that are resistant to Venetoclax and BTKi this has a short median progression free survival time, less than 2 years. It's a bridging treatment to get to the next treatment or wait for a trial to open.

nice.org.uk/guidance/indeve...

There are trials. They have short enrolment windows and there may not be suitable one when it's needed. A new class of BTK degrader is in trials now, you can't depend on it being open when and if he needs it. If he started on a trial but fails to respond to a drug then AlloSCT will be the next treatment.

[sue6741 in reply to Skyshark]

Thank you for your reply, the only thing consultant said was no other tablets with brutinib on end would work as ibrutinib stopped working hence ventaclax. I was under the impression that if he needs another treatment he could go back on ventaclax. Think it was alot to take in when Allograft was mentioned, I assumed we would carry on until he needed more treatment and there would be another tabket. He got 16months after being diagnosed, then 16 months after FCR, 4yrs on ibrutinib then 2yrs on ventaclax. He never had many side effects on any treatment and seems very well now. He suffers more from the face shingles he had in 2022, that was very bad. I don't know much and am trying to learn. This site helps alot.

[Skyshark in reply to sue6741]

Yes Venetoclax with or without Rituximab can be repeated.