Hematopoietic stem cell transplantation in chronic lymphocytic leukemia: a report of 12 patients from a single institution

Annals of Oncology : Official Journal of the European Society for Medical Oncology
Jordi EsteveEmili Montserrat

Abstract

Stem-cell transplantation is a reasonable therapeutic approach for younger patients with high-risk CLL. Twelve patients (seven males; median age 47 years, range 29-51) with high-risk CLL underwent transplantation (allo, n = 7; auto, n = 5). The conditioning regimen consisted of cyclophosphamide and total body irradiation in 11 patients, and BEAC in the remaining one. Minimal residual disease (MRD) was assessed by cytofluorometry and PCR. All 11 evaluable patients engrafted. Of the seven allografted patients, two died of treatment-related causes; three patients developed acute GVHD. No transplant-related mortality was observed in autografted patients. After transplantation, 10 of 11 patients evaluable for response achieved CR (91%; 95% CI 59%-100%) which was molecular in nine patients (82%; 95% CI 48%-98%). One patient in CR but MRD+ relapsed nine months after transplantation and died. Seven patients remain in molecular CR for a median of 16 months (range 1-58). Estimated actuarial survival and disease-free survival at two years is 81% (95% CI 43%-100%) and 71% (95% CI 43%-99%), respectively. Relapse risk at two years is 12.5% (95% CI 0%-35.5%). Patients with high-risk CLL can achieve long-lasting molecular CR after SCT. The rol...Continue Reading

Citations

Aug 31, 2002·Hematological Oncology·Gerassimos A PangalisMaria K Angelopoulou
Nov 25, 2003·Hematology·Michael J KeatingThomas J Kipps
Mar 2, 2005·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Paul MoretonPeter Hillmen
Apr 4, 2000·Bone Marrow Transplantation·Z S PavleticM R Bishop
Nov 5, 1999·Current Opinion in Hematology·A Krackhardt, J G Gribben

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