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Long-term survival of patients with CLL after allogeneic transplantation : A report from the European Society for Blood and Marrow Transplantation

Gelder, Marion E Meijer-Van; De Wreede, L. C.; Bornhäuser, M.; Niederwieser, D; Karas, M.; Anderson, N. S.; Gramatzki, Martin; Dreger, P.; Michallet, Mauricette and Petersen, Bo E, et al. (2017) In Bone Marrow Transplantation 52(3). p.372-380
Abstract

Even with the availability of targeted drugs, allogeneic hematopoietic cell transplantation (allo-HCT) is the only therapy with curative potential for patients with CLL. Cure can be assessed by comparing long-term survival of patients to the matched general population. Using data from 2589 patients who received allo-HCT between 2000 and 2010, we used landmark analyses and methods from relative survival analysis to calculate excess mortality compared with an age-, sex- and calendar year-matched general population. Estimated event-free survival, overall survival and non-relapse mortality (NRM) 10 years after allo-HCT were 28% (95% confidence interval (CI), 25-31), 35% (95% CI, 32-38) and 40% (95% CI, 37-42), respectively. Patients who... (More)

Even with the availability of targeted drugs, allogeneic hematopoietic cell transplantation (allo-HCT) is the only therapy with curative potential for patients with CLL. Cure can be assessed by comparing long-term survival of patients to the matched general population. Using data from 2589 patients who received allo-HCT between 2000 and 2010, we used landmark analyses and methods from relative survival analysis to calculate excess mortality compared with an age-, sex- and calendar year-matched general population. Estimated event-free survival, overall survival and non-relapse mortality (NRM) 10 years after allo-HCT were 28% (95% confidence interval (CI), 25-31), 35% (95% CI, 32-38) and 40% (95% CI, 37-42), respectively. Patients who passed the 5-year landmark event-free survival (N=394) had a 79% probability (95% CI, 73-85) of surviving the subsequent 5 years without an event. Relapse and NRM contributed equally to treatment failure. Five-year mortality for 45- and 65-year-old reference patients who were event-free at the 5-year landmark was 8% and 47% compared with 3% and 14% in the matched general population, respectively. The prospect of long-term disease-free survival remains an argument to consider allo-HCT for young patients with high-risk CLL, and programs to understand and prevent late causes of failure for long-term survivors are warranted, especially for older patients.

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keywords
allogenic transplantation, blood transplantation, marrow transplantation, survival
in
Bone Marrow Transplantation
volume
52
issue
3
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9 pages
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Nature Publishing Group
external identifiers
  • scopus:85014577257
  • pmid:27941763
  • wos:000395827400006
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0268-3369
DOI
10.1038/bmt.2016.282
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English
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fcc5c1f4-5f0d-416e-8e9b-9719ff9a7d87
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2017-03-17 16:00:42
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2018-01-07 11:56:16
@article{fcc5c1f4-5f0d-416e-8e9b-9719ff9a7d87,
  abstract     = {<p>Even with the availability of targeted drugs, allogeneic hematopoietic cell transplantation (allo-HCT) is the only therapy with curative potential for patients with CLL. Cure can be assessed by comparing long-term survival of patients to the matched general population. Using data from 2589 patients who received allo-HCT between 2000 and 2010, we used landmark analyses and methods from relative survival analysis to calculate excess mortality compared with an age-, sex- and calendar year-matched general population. Estimated event-free survival, overall survival and non-relapse mortality (NRM) 10 years after allo-HCT were 28% (95% confidence interval (CI), 25-31), 35% (95% CI, 32-38) and 40% (95% CI, 37-42), respectively. Patients who passed the 5-year landmark event-free survival (N=394) had a 79% probability (95% CI, 73-85) of surviving the subsequent 5 years without an event. Relapse and NRM contributed equally to treatment failure. Five-year mortality for 45- and 65-year-old reference patients who were event-free at the 5-year landmark was 8% and 47% compared with 3% and 14% in the matched general population, respectively. The prospect of long-term disease-free survival remains an argument to consider allo-HCT for young patients with high-risk CLL, and programs to understand and prevent late causes of failure for long-term survivors are warranted, especially for older patients.</p>},
  author       = {Gelder, Marion E Meijer-Van and De Wreede, L. C. and Bornhäuser, M. and Niederwieser, D and Karas, M. and Anderson, N. S. and Gramatzki, Martin and Dreger, P. and Michallet, Mauricette and Petersen, Bo E and Bunjes, D. and Potter, Michael N and Beelen, D. and Cornelissen, Jan J and Yakoub-Agha, I. and Russell, Nigel H and Finke, J. and Schoemans, H. and Vitek, A and Urbano-Ispízua,  and Blaise, D. and Volin, L and Chevallier, Patrice and Caballero, Dolores and Putter, H. and van Biezen, Anja and Henseler, A. and Schönland, S O and Kröger, Nicolaus and Schetelig, J. and Ehninger, Gerhard and Niederwieser, Dietger and Jindra, Pavel and Sengeloev, Henrik and Gramatzki, Martin and Dreger, Peter and Petersen, Eefke and Bunjes, Donald and Potter, Michael N and Beelen, Dietrich and Cornelissen, Jan and Yakoub-Agha, Ibrahim and Russell, Nigel and Finke, Jürgen and Schoemans, Hélène and Vitek, Antonin and Ispizua, Alvaro Urbano and Blaise, Didier and Volin, Liisa and Arnold, Renate and Chevallier, Patrice and Caballero, Dolores and Veelken, Joan Hendrik and Mufti, Ghulam and Milpied, Noel and Benedetto, Bruno 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  issn         = {0268-3369},
  keyword      = {allogenic transplantation,blood transplantation,marrow transplantation,survival},
  language     = {eng},
  month        = {03},
  number       = {3},
  pages        = {372--380},
  publisher    = {Nature Publishing Group},
  series       = {Bone Marrow Transplantation},
  title        = {Long-term survival of patients with CLL after allogeneic transplantation : A report from the European Society for Blood and Marrow Transplantation},
  url          = {http://dx.doi.org/10.1038/bmt.2016.282},
  volume       = {52},
  year         = {2017},
}