Allogeneic hematopoietic stem-cell transplantation for chronic lymphocytic leukemia with 17p deletion: a retrospective European Group for Blood and Marrow Transplantation analysis.
OBJECTIVE
Patients with chronic lymphocytic leukemia (CLL) and 17p deletion (17p-) have a poor prognosis. Although allogeneic hematopoietic stem-cell transplantation (HCT) has the potential to cure patients with advanced CLL, it is not known whether this holds true for patients with 17p-CLL.


METHODS
Baseline data from patients, for whom information on the presence of 17p-CLL was available, were downloaded from the European Group for Blood and Marrow Transplantation database. Additional information on the course of CLL and follow-up was collected with a questionnaire.


RESULTS
A total of 44 patients with 17p-CLL received allogeneic HCT between March 1995 and July 2006 from a matched sibling (n = 24) or an alternative donor (n = 20). 17p-CLL had been diagnosed by fluorescent in situ hybridization in 82% of patients and by conventional banding in 18% of patients. The median age was 54 years. Before HCT, a median of three lines of chemotherapy had been administered. At HCT, 53% of patients were in remission. Reduced-intensity conditioning was applied in 89% of patients. Acute, grade 2 to 4 graft-versus-host disease (GVHD) occurred in 43% of patients, and extensive chronic GVHD occurred in 53% of patients. At last follow-up, 19 patients were alive, with a median observation time of 39 months (range, 18 to 101 months). Three-year overall survival and progression-free survival rates were 44% and 37%, respectively. The cumulative incidence of progressive disease at 4 years was 34%. No late relapse occurred in nine patients with a follow-up longer than 4 years.


CONCLUSIONS
Allogeneic HCT has the potential to induce long-term disease-free survival in patients with 17p-CLL.
Schetelig
Johannes
J
University Hospital Carl Gustav Carus, Medizinische Klinik und Poliklinik I, Dresden, Germany. johannes.schetelig@uniklinikum-dresden.de
van Biezen
Anja
A
Brand
Ronald
R
Caballero
Dolores
D
Martino
Rodrigo
R
Itala
Maija
M
García-Marco
José A
JA
Volin
Liisa
L
Schmitz
Norbert
N
Schwerdtfeger
Rainer
R
Ganser
Arnold
A
Onida
Francesco
F
Mohr
Brigitte
B
Stilgenbauer
Stephan
S
Bornhäuser
Martin
M
de Witte
Theo
T
Dreger
Peter
P
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002872:Chromosome Deletion; D002886:Chromosomes, Human, Pair 17; D018572:Disease-Free Survival; D005060:Europe; D005260:Female; D015973:Gene Expression Regulation, Leukemic; D006086:Graft vs Host Disease / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000235:genetics / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012042:Registries; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors; D014184:Transplantation, Homologous; D017211:Treatment Failure; D016896:Treatment Outcome