B-cell prolymphocytic leukemia (B-PLL) is a rare lymphoid
neoplasm with an aggressive
clinical course. Treatment strategies for B-PLL remain to be established, and, until recently,
alemtuzumab was the only effective therapeutic option in patients harboring 17p deletions. Herein, we describe, for the first time, a case of
B-cell prolymphocytic leukemia harboring a 17p deletion in a 48-year-old man that was successfully treated sequentially with
idelalisib-
rituximab/
ibrutinib followed by allogeneic hematopoietic stem cell transplant (allo-HSCT). After 5 months of
therapy with
idelalisib-
rituximab, clinical remission was achieved, but the development of severe
diarrhea led to its discontinuation. Subsequently, the patient was treated for 2 months with
ibrutinib and the quality of the response was maintained with no severe adverse effects reported. A reduced-intensity conditioning allo-HSCT from a HLA-matched unrelated donor was performed, and, thereafter, the patient has been
in complete remission for 10 months now. In conclusion, given the poor prognosis of B-PLL and the lack of effective treatment modalities, the findings here suggest that both
ibrutinib and
idelalisib should be considered as upfront
therapy of B-PLL and as a bridge to allo-HSCT.