Autologous stem cell transplantation in patients with chronic lymphocytic leukaemia: the Finnish experience.
Although autologous stem cell transplantation (ASCT) has gained some popularity as a treatment option in patients with chronic lymphocytic leukaemia (CLL), limited multicentre data are available on the feasibility and efficacy of this approach. Between January 1995 and June 2005, 72 patients with CLL received ASCT in five Finnish centres. There were 45 men and 27 women with a median age of 57 years (38-69). The median time from diagnosis to ASCT was 32 months (6-181) and the median number of prior regimens 1 (1-4). All patients received blood stem cell grafts and CD34+ selection had been performed in 44 patients (61%). The most common high-dose regimen was a total body irradiation plus cyclophosphamide (38 patients, 53%). No early treatment-related deaths were observed. With a median follow-up of 28 months from ASCT, a relapse or progression has been observed in 27 patients (37%). The projected progression-free survival is 48 months (confidence interval (CI) 30-66). The projected median overall survival is 95 months (CI 74-101) from ASCT and is not influenced by graft selection or conditioning regimen used. Autologous stem cell transplantation is a feasible treatment option for CLL. Randomized trials against alternative treatments are needed to assess the impact of ASCT on the clinical course of CLL.
Jantunen
E
E
Department of Medicine, Kuopio University Hospital, 70211 Kuopio, Finland. esa.jantunen@kuh.fi
Itälä
M
M
Siitonen
T
T
Juvonen
E
E
Koivunen
E
E
Koistinen
P
P
Volin
L
L
Remes
K
K
Nousiainen
T
T
D000328:Adult; D000368:Aged; D003520:Cyclophosphamide / Q000008:administration & dosage; D018572:Disease-Free Survival; D005260:Female; D005387:Finland; D005500:Follow-Up Studies; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D019653:Myeloablative Agonists / Q000008:administration & dosage; D012008:Recurrence; D012189:Retrospective Studies; D033581:Stem Cell Transplantation / Q000401:mortality; D015996:Survival Rate; D019172:Transplantation Conditioning / Q000401:mortality; D014182:Transplantation, Autologous; D014916:Whole-Body Irradiation / Q000401:mortality
D019653:Myeloablative Agonists; D003520:Cyclophosphamide