title: Allogeneic hematopoietic stem cell transplant with reduced-intensity conditioning for chronic lymphocytic leukemia in Sweden: does donor T-cell engraftment 3 months after transplant predict survival?
abstract: Thirty-eight adult patients with chronic lymphocytic leukemia (CLL) underwent reduced-intensity conditioning (RIC) allogeneic stem cell transplant (allo-SCT) in Sweden between 1999 and 2007. The cumulative incidences of acute graft-versus-host disease (GVHD) grades II-IV and chronic GVHD were 29% and 47%, respectively. Rates of non-relapse mortality, progression-free survival (PFS) and overall survival (OS) were 18%, 47% and 74% at 1 year, and 21%, 25% and 45% at 5 years, respectively. T-cell chimerism after transplant was measured in 31 out of 34 patients (91%) surviving beyond day +100. Seventeen patients achieved >90% donor T-cell engraftment at 3 months after allo-SCT and, compared with the 12 patients with ≤90% donor T-cell engraftment, they showed favorable PFS at 1 year (82% vs. 33%, p =0.002) and better long-term PFS and OS (p =0.002 and 0.046, respectively). Donor T-cell engraftment of >90% at 3 months after RIC allo-SCT for CLL seems to predict favorable short-term and long-term outcome.
authors.affiliation: Division of Hematology, Department of Medicine at Huddinge, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden.
authors.forename: Maciej
authors.initials: M
authors.lastname: Machaczka
authors.forename: Jan-Erik
authors.initials: JE
authors.lastname: Johansson
authors.forename: Mats
authors.initials: M
authors.lastname: Remberger
authors.forename: Helene
authors.initials: H
authors.lastname: Hallböök
authors.forename: Claes
authors.initials: C
authors.lastname: Malm
authors.forename: Vladimir Lj
authors.initials: VLj
authors.lastname: Lazarevic
authors.forename: Anders
authors.initials: A
authors.lastname: Wahlin
authors.forename: Hamdy
authors.initials: H
authors.lastname: Omar
authors.forename: Gunnar
authors.initials: G
authors.lastname: Juliusson
authors.forename: Eva
authors.initials: E
authors.lastname: Kimby
authors.forename: Hans
authors.initials: H
authors.lastname: Hägglund
mesh_terms: D000208:Acute Disease; D000328:Adult; D002908:Chronic Disease; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006086:Graft vs Host Disease / Q000175:diagnosis; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D018365:Neoplasm, Residual / Q000175:diagnosis; D011379:Prognosis; D012008:Recurrence; D013548:Sweden; D013601:T-Lymphocytes / Q000378:metabolism / Q000637:transplantation; D013997:Time Factors; D019172:Transplantation Conditioning / Q000379:methods*; D014184:Transplantation, Homologous; D016896:Treatment Outcome