title: The impact of allogeneic stem cell transplantation on the natural course of poor-risk chronic lymphocytic leukemia as defined by the EBMT consensus criteria: a retrospective donor versus no donor comparison.
abstract: BACKGROUND
  In a single-center retrospective donor versus no-donor comparison, we investigated if allogeneic stem cell transplantation (alloSCT) can improve the dismal course of poor-risk chronic lymphocytic leukemia (CLL).
  
  
  METHODS
  All patients with CLL who were referred for evaluation of alloSCT within a 7-year time frame and had a donor search indication according to the EBMT criteria or because of Richter's transformation were included. Patients for whom a matched donor could be found within 3 months (matches) were compared with patients without such a donor (controls). Primary end point was overall survival measured from the 3-month landmark after search initiation.
  
  
  RESULTS
  Of 105 patients with donor search, 97 (matches 83; controls 14) were assessable at the 3-month landmark. Matches and controls were comparable for age, gender, time from diagnosis, number of previous regimens, and remission status. Disregarding if alloSCT was actually carried out or not, survival from the 3-month landmark was significantly better in matches versus controls [hazard ratio 0.38, 95% confidence interval (CI) 0.17-0.85; P = 0.014]. The survival benefit of matches remained significant on multivariate analysis.
  
  
  CONCLUSIONS
  This study provides first comparative evidence that alloSCT may have the potential to improve the natural course of poor-risk CLL as defined by the EBMT criteria.
authors.affiliation: Department Medicine V, University of Heidelberg, Heidelberg.
authors.forename: I
authors.initials: I
authors.lastname: Herth
authors.forename: S
authors.initials: S
authors.lastname: Dietrich
authors.forename: A
authors.initials: A
authors.lastname: Benner
authors.forename: U
authors.initials: U
authors.lastname: Hegenbart
authors.forename: M
authors.initials: M
authors.lastname: Rieger
authors.forename: P
authors.initials: P
authors.lastname: Stadtherr
authors.forename: A
authors.initials: A
authors.lastname: Bondong
authors.forename: T H
authors.initials: TH
authors.lastname: Tran
authors.forename: R
authors.initials: R
authors.lastname: Weide
authors.forename: M
authors.initials: M
authors.lastname: Hensel
authors.forename: W
authors.initials: W
authors.lastname: Knauf
authors.forename: J
authors.initials: J
authors.lastname: Franz-Werner
authors.forename: M
authors.initials: M
authors.lastname: Welslau
authors.forename: M
authors.initials: M
authors.lastname: Procaccianti
authors.forename: M
authors.initials: M
authors.lastname: Görner
authors.forename: J
authors.initials: J
authors.lastname: Meissner
authors.forename: T
authors.initials: T
authors.lastname: Luft
authors.forename: S
authors.initials: S
authors.lastname: Schönland
authors.forename: M
authors.initials: M
authors.lastname: Witzens-Harig
authors.forename: T
authors.initials: T
authors.lastname: Zenz
authors.forename: A D
authors.initials: AD
authors.lastname: Ho
authors.forename: P
authors.initials: P
authors.lastname: Dreger
mesh_terms: D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012306:Risk; D033581:Stem Cell Transplantation; D014019:Tissue Donors; D014184:Transplantation, Homologous; D016896:Treatment Outcome
keywords: CLL; alloSCT; donor