The role of hematopoietic stem cell transplantation in Chronic Lymphocytic Leukemia

Banerji, Versha; Johnston, James B.; Seftel, Matthew D.

doi:10.1016/j.transci.2007.04.008

Cited by 4 publications

(2 citation statements)

References 40 publications

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“…Most studies suggest overall 2-year survival rates with RIC transplant in the range of 54-75% and TRM of 7-22% [7] and these figures appear better than in myeloablative transplants. The field of RIC, however, is still evolving as a few studies have reported higher incidence of relapse than myeloablative conditioning regimen [27].…”

Section: Discussionmentioning

confidence: 99%

Long-term outcome of allogeneic stem cell transplantation in chronic lymphocytic leukemia: analysis after a minimum follow-up of 5 years

Malhotra

Litzow

Gastineau

et al. 2008

Leukemia & Lymphoma

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In order to evaluate the long-term results of allogeneic stem cell transplantation (ASCT) in B-cell chronic lymphocytic leukemia (CLL), we reviewed the outcome of 12 consecutive CLL patients, who underwent ASCT at the Mayo Clinic prior to July, 2004. Median age was 44 years (range 18-55) and median time from diagnosis to transplant 58.5 months. All patients had failed prior fludarabine-based chemotherapy and all but two patients had chemo-resistant refractory disease at time of transplant. A 'myeloablative' conditioning regimen was used in 11 patients and 'reduced intensity' in one. Bone marrow was the source of hematopoietic stem cells in 10 patients and peripheral blood in two. Donors were matched sibling in nine patients, unrelated in two and partial phenotypic match father in one. Grade II-IV acute and chronic graft versus host disease was documented in five and four patients, respectively. To date, six patients (50%) have died including four early deaths from infection. Complete remission (CR) was documented in eight patients (66.7%) post-transplant; six are currently alive whereas one died at 7 months from infection while still in CR and one relapsed 7 months post-transplant and died later. One CR patient relapsed after 4.5 years but was successfully re-transplanted and remains in second CR for 6.5+ years. Another patient recently relapsed after 10.5 years of CR. Duration of ASCT-induced CR in the remaining four patients was 6.5+, 8.5+, 9+ and 10+ years. All surviving patients displayed excellent performance status without ongoing chronic graft versus host disease. We conclude that ASCT is an effective salvage therapy for fludarabine-refractory CLL but late relapses can occur.

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Section: Discussionmentioning

confidence: 99%

Long-term outcome of allogeneic stem cell transplantation in chronic lymphocytic leukemia: analysis after a minimum follow-up of 5 years

Malhotra

Litzow

Gastineau

et al. 2008

Leukemia & Lymphoma

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“…Nevertheless, no studies have directly addressed whether TBI-based (200 cGy) NMA conditioning regimens results in different outcomes compared to no-TBI regimens for LD [ 8 , 9 ]. Meta-analyses comparing different NMA regimens both with and without TBI showed conflicting results, including incidence of acute and chronic GVHD, engraftment, and survival [ 10 – 12 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison of non-myeloablative conditioning regimens for lymphoproliferative disorders

Hong

Le‐Rademacher

Artz

et al. 2014

Bone Marrow Transplant

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Hematopoietic cell transplantation (HCT) with non-myeloablative conditioning (NMA) for lymphoproliferative diseases (LD) includes fludarabine with and without low-dose total body irradiation (TBI). Transplant outcomes were compared among patients ≥40 years with LD who received a HCT with TBI (N=382) and no-TBI (N=515) NMA from 2001 to 2011. The groups were comparable except for donor, graft, prophylaxis for graft-versus-host disease (GVHD), disease status and year of HCT. Cumulative incidences of grades II–IV GVHD at 100 days, were 29% and 20% (p=0.001), and chronic GVHD at 1 year were 54% and 44% (p=0.004) for TBI and no-TBI, respectively. Multivariate analysis of progression/relapse, treatment failure and mortality showed no outcome differences by conditioning. Full donor chimerism at day 100 was observed in 82% vs. 64% in the TBI and no-TBI groups, respectively (p=0.006). Subset of four most common conditioning/ GVHD prophylaxis combinations demonstrated higher rates of grades II–IV acute (p<0.001) and chronic GVHD (p<0.001) among recipients of TBI-mycophenolate mofetil (MMF) compared to other combinations. TBI-based NMA conditioning induces faster full donor chimerism but overall survival outcomes are comparable to no-TBI regimens. Combination of TBI and MMF are associated with higher rates of GVHD without impact on survival outcomes in patients with LD.

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Current Awareness in Hematological Oncology

2008

Hematological Oncology

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In order to keep subscribers up‐to‐date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of hematological oncology. Each bibliography is divided into 14 sections: 1 Reviews; 2 General; Leukemias: 3 Lymphoblastic; 4 Myeloid & Myelodysplastic Syndromes; 5 Chronic; 6 Others; Lymphomas: 7 Hodgkin's; 8 Non‐Hodgkin's; 9 Plasmacytomas/Multiple Myelomas; 10 Others; 11 Bone Marrow Transplantation; 12 Cytokines; 13 Diagnosis; 14 Cytogenetics. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted.

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The role of hematopoietic stem cell transplantation in Chronic Lymphocytic Leukemia

Cited by 4 publications

References 40 publications

Long-term outcome of allogeneic stem cell transplantation in chronic lymphocytic leukemia: analysis after a minimum follow-up of 5 years

Long-term outcome of allogeneic stem cell transplantation in chronic lymphocytic leukemia: analysis after a minimum follow-up of 5 years

Comparison of non-myeloablative conditioning regimens for lymphoproliferative disorders

Current Awareness in Hematological Oncology

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