Indications for Stem Cell Transplant in CLL; EBMT Consensus

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Leukemia. 2006 Nov 16; [Epub ahead of print]

Indications for allogeneic stem cell transplantation in chronic

lymphocytic leukemia: the EBMT transplant consensus.

Dreger P, Corradini P, Kimby E, Michallet M, Milligan D, Schetelig

J, Wiktor-Jedrzejczak W, Niederwieser D, Hallek M, Montserrat E.

1Department of Medicine V, University of Heidelberg, Heidelberg,

Germany.

The aim of this project was to identify situations where allogeneic

stem cell transplantation (allo-SCT) might be considered as a

preferred treatment option for patients with B-cell chronic

lymphocytic leukemia (CLL). Based on a MEDLINE search and additional

sources, a consented proposal was drafted, refined and approved upon

final discussion by an international expert panel.

Key elements of the consensus are (1) allo-SCT is a procedure with

evidence-based efficacy in poor-risk CLL; (2) although definition

of 'poor-risk CLL' requires further investigation, allo-SCT is a

reasonable treatment option for younger patients with (i) non-

response or early relapse (within 12 months) after purine analogues,

(ii) relapse within 24 months after having achieved a response with

purine-analogue-based combination therapy or autologous

transplantation, and (iii) patients with p53 abnormalities requiring

treatment; and (3) optimum transplant strategies may vary according

to distinct clinical situations and should be defined in prospective

trials.

This is the first attempt to define standard indications for allo-

SCT in CLL. Nevertheless, whenever possible, allo-SCT should be

performed within disease-specific prospective clinical protocols in

order to continuously refine transplant indications according to new

developments in risk assessment and treatment of CLL.

Leukemia advance online publication, 16 November 2006;

doi:10.1038/sj.leu.2404441.

PMID: 17109028 [PubMed - as supplied by publisher]