The effect of allogeneic stem cell transplantation on high risk chronic lymphocytic leukaemia: a single centre retrospective analysis.

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BlankThe effect of allogeneic stem cell transplantation on high risk chronic

lymphocytic leukaemia: a single centre retrospective analysis.

V Valkova, J Schwarz, A Vitek, M Markova, D Pohlreich, K Benesova, K Michalova,

P Cetkovsky, and M Trneny

Hematol Oncol, June 10, 2010; .

Institute of Haematology and Blood Transfusion, Prague, Czech Republic.

In recent years, many studies have confirmed that allogeneic stem cell

transplantation (allo-SCT) can provide long-term disease control and possible

cure in selected patients with chronic lymphocytic leukaemia (CLL), including

those with a biologically highly unfavourable risk profile. A retrospective

analysis of allo-SCT in 30 patients with CLL whose risk profile was unfavourable

and who were treated in the years 2000-2009 was performed. The aim was to

compare the results of allo-SCT by prognostic factors and conditioning type and

evaluate the results of unrelated transplantation. The median age was 54 years.

Donors were 8 HLA-matched siblings and 22 unrelated volunteers, 11 of whom were

mismatched. Eighteen patients were treated with reduced intensity conditioning.

Twelve patients received myeloablative conditioning. Estimated overall survival

(OS) at 3 years was 78%, progression-free survival (PFS) 71%, relapse incidence

10% and non-relapse mortality (NRM) 16%, respectively, with a median follow-up

of 35 months. According to molecular/cytogenetic characteristics, OS and PFS for

the high risk group (17p- or 11q-) were 89 and 77%, respectively, not

significantly different from those with standard risk. Graft-versus-host disease

(GVHD) was associated with greater toxicity; significantly higher NRM for

patients with aGVHD (p = 0.04) and worse PFS for patients with cGVHD (p = 0.04).

Our results for the refractory disease group (77% responses) indicate that

chemoresistance may be overcome by the GVL effect. Transplants from unrelated

donors may be considered comparable to those from related donors. Copyright ©

2010 Wiley & Sons, Ltd.

PMID: 20535783