Allogeneic Hematopoietic Stem-Cell Transplantation for Chronic Lymphocytic Leukemia With 17p Deletion: A Retrospective European Group for Blood and Marrow Transplantation Analysis

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JCO Early Release, published online ahead of print Aug 18 2008

Journal of Clinical Oncology, 10.1200/JCO.2008.16.2982

Allogeneic Hematopoietic Stem-Cell Transplantation for Chronic Lymphocytic

Leukemia With 17p Deletion: A Retrospective European Group for Blood and Marrow

Transplantation Analysis

Johannes Schetelig1,* Anja van Biezen2, Brand2, Dolores Caballero2,

Rodrigo o2, Maija Itala2, José A. García-Marco2, Liisa Volin2, Norbert

Schmitz2, Rainer Schwerdtfeger2, Arnold Ganser2, Francesco Onida2, Brigitte

Mohr2, Stephan Stilgenbauer2, Bornhäuser2, Theo de Witte2, and

Dreger2

1 From the University Hospital Carl Gustav Carus, Medizinische Klinik und

Poliklinik I, Dresden; Department of Haematology and Stem Cell Transplantation,

Asklepios Klinik St Georg, Hamburg; Deutsche Klinik für Diagnostik,

Knochenmarktransplantation, Wiesbaden; Hannover Medical University, Department

of Haematology/Oncology, Hannover; University Hospital, Medizinische Klinik und

Poliklinik III, Ulm; University Hospital Heidelberg, Medizinische Klinik V,

Heidelberg, Germany; Hospital Clínico, Servicio de Hematología, Salamanca;

Hospital Santa Creu i Sant Pau, Clinical Haematology Division, Universitat

Autonoma de Barcelona, Barcelona; Hospital Universitario Puerta de Hierro,

Servicio de Hematologia, Madrid, Spain; Turku University, Central Hospital, Bone

Marrow Transplantation Unit, Turku; Helsinki University Central Hospital,

Helsinki, Finland; Fondazione Istituto di Ricovero e Cura a Carattere

Scientifico, Ospedale Maggiore Policlinico Mangiagalli e Regina Elena and

University of Milan, Milano, Italy; Chronic Leukemia Working Party, Department

of Medical Statistics and Bioinformatics, Leiden University Medical Center,

Leiden; and Department of Hematology, Radboud University-Nijmegen Medical

Centre, Nijmegen, the Netherlands.

2 From the University Hospital Carl Gustav Carus, Medizinische Klinik und

Poliklinik I, Dresden; Department of Haematology and Stem Cell Transplantation,

Asklepios Klinik St Georg, Hamburg; Deutsche Klinik für Diagnostik,

Knochenmarktransplantation, Wiesbaden; Hannover Medical University, Department

of Haematology/Oncology, Hannover; University Hospital, Medizinische Klinik und

Poliklinik III, Ulm; University Hospital Heidelberg, Medizinische Klinik V,

Heidelberg, Germany; Hospital Clínico, Servicio de Hematología, Salamanca;

Hospital Santa Creu i Sant Pau, Clinical Haematology Division, Universitat

Autonoma de Barcelona, Barcelona; Hospital Universitario Puerta de Hierro,

Servicio de Hematologia, Madrid, Spain; Turku University, Central Hospital, Bone

Marrow Transplantation Unit, Turku; Helsinki University Central Hospital,

Helsinki, Finland; Fondazione Istituto di Ricovero e Cura a Carattere

Scientifico, Ospedale Maggiore Policlinico Mangiagalli e Regina Elena and

University o Milan, Milano, Italy; Chronic Leukemia Working Party, Department of

Medical Statistics and Bioinformatics, Leiden University Medical Center, Leiden;

and Department of Hematology, Radboud University-Nijmegen Medical Centre,

Nijmegen, the Netherlands.

* To whom correspondence should be addressed. E-mail:

johannes.schetelig@...

Purpose: Patients with chronic lymphocytic leukemia (CLL) and 17p deletion

(17p-) have a poor prognosis. Although allogeneic hematopoietic stem-cell

transplantation (HCT) has the potential to cure patients with advanced CLL, it

is not known whether this holds true for patients with 17p- CLL.

Patients and Methods: Baseline data from patients, for whom information on the

presence of 17p- CLL was available, were downloaded from the European Group for

Blood and Marrow Transplantation database. Additional information on the course

of CLL and follow-up was collected with a questionnaire.

Results: A total of 44 patients with 17p- CLL received allogeneic HCT between

March 1995 and July 2006 from a matched sibling (n = 24) or an alternative donor

(n = 20). 17p- CLL had been diagnosed by fluorescent in situ hybridization in

82% of patients and by conventional banding in 18% of patients. The median age

was 54 years. Before HCT, a median of three lines of chemotherapy had been

administered. At HCT, 53% of patients were in remission. Reduced-intensity

conditioning was applied in 89% of patients. Acute, grade 2 to 4

graft-versus-host disease (GVHD) occurred in 43% of patients, and extensive

chronic GVHD occurred in 53% of patients. At last follow-up, 19 patients were

alive, with a median observation time of 39 months (range, 18 to 101 months).

Three-year overall survival and progression-free survival rates were 44% and

37%, respectively. The cumulative incidence of progressive disease at 4 years

was 34%. No late relapse occurred in nine patients with a follow-up longer than

4 years.

Conclusion: Allogeneic HCT has the potential to induce long-term disease-free

survival in patients with 17p- CLL.