Practical Aspects of Allogeneic Hematopoietic Cell Transplantation for Patients with Poor-Risk Chronic Lymphocytic Leukemia

Abstract

Allogeneic hematopoietic cell transplantation has become a viable option for younger patients with poor-risk chronic lymphocytic leukemia. The results obtained with either conventional or reduced-intensity conditioning regimens have been recently evaluated and compared with alternative nontransplant strategies. This manuscript deals with practical aspects of the procedure, including patient and donor selection, conditioning regimen, GVHD prophylaxis, disease monitoring, infectious and noninfectious complications, and timing of the procedure. Finally, we speculate on how we could improve the results obtained with the procedure and new advances currently in clinical trials.

Upper Respiratory Tract Colonization by Gram-Negative Rods in Patients with Chronic Lymphocytic Leukemia: Analysis of Risk Factors

“…The major risk factors for infection in these patients are immune defects that are inherent to the primary disease process and therapy-related immunosuppression. Refractory CLL patients subjected to allogenic hematopoietic cell transplantation (allo-HCT) also have a particularly high incidence of infections compared to allo-HCT recipients with other lymphoid malignancies [ 5 , 6 ] Disease- and therapy-related immune defects include hypogammaglobulinemia, as well as perturbations in cell-mediated immunity, complement activity, and neutrophil function [ 4 , 7 ].…”