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High incidence of chronic graft-versus-host disease after myeloablative allogeneic stem cell transplantation for chronic lymphocytic leukemia in Sweden : graft-versus-leukemia effect protects against relapse

Machaczka, Maciej ; Johansson, Jan-Erik ; Remberger, Mats ; Hallböök, Helene ; Lazarevic, Vladimir Lj LU ; Wahlin, Björn Engelbrekt ; Omar, Hamdy ; Wahlin, Anders ; Juliusson, Gunnar LU and Kimby, Eva , et al. (2013) In Medical Oncology 30(4). p.762-762
Abstract

Allogeneic hematopoietic stem cell transplantation (allo-SCT) is a potentially curative treatment option for eligible patients with chronic lymphocytic leukemia (CLL). However, it is known that cure of CLL is only possible if a graft-versus-leukemia effect is present. Between 1994 and 2007, 48 adults underwent allo-SCT for poor-risk CLL in Sweden. Of these, ten (21%) patients aged 24-53 years (median: 46 years) received myeloablative conditioning (MAC), based on TBI and cyclophosphamide. All MAC patients had refractory, poorly controlled CLL before allo-SCT (partial remission in 9/10 patients and progressive disease in one). The cumulative incidence of acute graft-versus-host disease (GVHD) grades II-IV was 30%. Nine patients developed... (More)

Allogeneic hematopoietic stem cell transplantation (allo-SCT) is a potentially curative treatment option for eligible patients with chronic lymphocytic leukemia (CLL). However, it is known that cure of CLL is only possible if a graft-versus-leukemia effect is present. Between 1994 and 2007, 48 adults underwent allo-SCT for poor-risk CLL in Sweden. Of these, ten (21%) patients aged 24-53 years (median: 46 years) received myeloablative conditioning (MAC), based on TBI and cyclophosphamide. All MAC patients had refractory, poorly controlled CLL before allo-SCT (partial remission in 9/10 patients and progressive disease in one). The cumulative incidence of acute graft-versus-host disease (GVHD) grades II-IV was 30%. Nine patients developed chronic GVHD; extensive in four. Rates of nonrelapse mortality at 1, 3 and 10 years were 0, 10 and 20%, respectively. Two patients relapsed 36 and 53 months after transplantation. Six patients were still alive after a median follow-up time of 11.5 years (range 5.9-13.7). The probabilities of relapse-free and overall survival from 1, 3 and 5 years after transplantation were 100, 90 and 70%, and 100, 90 and 80%, respectively. Nevertheless, our analysis of long-term outcome after MAC allo-SCT for CLL suggests that younger patients with poorly controlled CLL may benefit from MAC allo-SCT.

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publication status
published
subject
keywords
Adult, Disease Progression, Female, Graft vs Host Disease, Graft vs Leukemia Effect, Hematopoietic Stem Cell Transplantation, Humans, Kaplan-Meier Estimate, Leukemia, Lymphocytic, Chronic, B-Cell, Male, Middle Aged, Sweden, Transplantation, Homologous, Young Adult
in
Medical Oncology
volume
30
issue
4
pages
762 - 762
publisher
Humana Press
external identifiers
  • scopus:84886973685
  • pmid:24214180
ISSN
1559-131X
DOI
10.1007/s12032-013-0762-x
language
English
LU publication?
yes
id
8310bbf6-19f5-4982-bc93-3f8ed8ecf7b6
date added to LUP
2016-05-24 17:15:30
date last changed
2021-07-21 03:32:34
@article{8310bbf6-19f5-4982-bc93-3f8ed8ecf7b6,
  abstract     = {<p>Allogeneic hematopoietic stem cell transplantation (allo-SCT) is a potentially curative treatment option for eligible patients with chronic lymphocytic leukemia (CLL). However, it is known that cure of CLL is only possible if a graft-versus-leukemia effect is present. Between 1994 and 2007, 48 adults underwent allo-SCT for poor-risk CLL in Sweden. Of these, ten (21%) patients aged 24-53 years (median: 46 years) received myeloablative conditioning (MAC), based on TBI and cyclophosphamide. All MAC patients had refractory, poorly controlled CLL before allo-SCT (partial remission in 9/10 patients and progressive disease in one). The cumulative incidence of acute graft-versus-host disease (GVHD) grades II-IV was 30%. Nine patients developed chronic GVHD; extensive in four. Rates of nonrelapse mortality at 1, 3 and 10 years were 0, 10 and 20%, respectively. Two patients relapsed 36 and 53 months after transplantation. Six patients were still alive after a median follow-up time of 11.5 years (range 5.9-13.7). The probabilities of relapse-free and overall survival from 1, 3 and 5 years after transplantation were 100, 90 and 70%, and 100, 90 and 80%, respectively. Nevertheless, our analysis of long-term outcome after MAC allo-SCT for CLL suggests that younger patients with poorly controlled CLL may benefit from MAC allo-SCT.</p>},
  author       = {Machaczka, Maciej and Johansson, Jan-Erik and Remberger, Mats and Hallböök, Helene and Lazarevic, Vladimir Lj and Wahlin, Björn Engelbrekt and Omar, Hamdy and Wahlin, Anders and Juliusson, Gunnar and Kimby, Eva and Hägglund, Hans},
  issn         = {1559-131X},
  language     = {eng},
  number       = {4},
  pages        = {762--762},
  publisher    = {Humana Press},
  series       = {Medical Oncology},
  title        = {High incidence of chronic graft-versus-host disease after myeloablative allogeneic stem cell transplantation for chronic lymphocytic leukemia in Sweden : graft-versus-leukemia effect protects against relapse},
  url          = {http://dx.doi.org/10.1007/s12032-013-0762-x},
  doi          = {10.1007/s12032-013-0762-x},
  volume       = {30},
  year         = {2013},
}