title: Long-term survival of patients with CLL after allogeneic transplantation: a report from the European Society for Blood and Marrow Transplantation.
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 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.
authors.affiliation: Department of Internal Medicine/Hematology, University Hospital Maastricht, Maastricht, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: van Gelder
authors.affiliation: DKMS, gemeinnützige GmbH, Tübingen, Germany.|Department of Medical Statistics and Bioinformatics, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: L C
authors.initials: LC
authors.lastname: de Wreede
authors.affiliation: Medizinische Klinik und Poliklinik I, Universitätsklinikum Dresden, Technische Universität Dresden, Dresden, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Bornhäuser
authors.affiliation: Division of Hematology, Oncology and Hemostasiology, University Hospital Leipzig, Leipzig, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Niederwieser
authors.affiliation: Department of Hematology/Oncology, Charles University Hospital, Pilsen, Czech Republic.
authors.forename: M
authors.initials: M
authors.lastname: Karas
authors.affiliation: BMT Unit, Department of Hematology, Rigshospitalet, Copenhagen, Denmark.
authors.forename: N S
authors.initials: NS
authors.lastname: Anderson
authors.affiliation: Division of Stem Cell Transplantation and Immunotherapy, University Hospital Schleswig-Holstein, Kiel, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Gramatzki
authors.affiliation: Medizinische Klinik und Poliklinik V, University of Heidelberg, Heidelberg, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Dreger
authors.affiliation: Center Hospitalier Lyon-Sud - Hématologie, Lyon, France.
authors.forename: M
authors.initials: M
authors.lastname: Michallet
authors.affiliation: Department of Haematology, University Medical Center, Utrecht, The Netherlands.
authors.forename: E
authors.initials: E
authors.lastname: Petersen
authors.affiliation: Klinik fuer Innere Medizin III, Universitätsklinikum Ulm, Ulm, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Bunjes
authors.affiliation: Leukaemia Myeloma Units, Royal Marsden Hospital, London, Surrey, UK.
authors.forename: M
authors.initials: M
authors.lastname: Potter
authors.affiliation: Department of Bone Marrow Transplantation, University Hospital, Essen, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Beelen
authors.affiliation: Erasmus MC-Daniel den Hoed Cancer Center, Rotterdam, The Netherlands.
authors.forename: J J
authors.initials: JJ
authors.lastname: Cornelissen
authors.affiliation: Hôpital HURIEZ, UAM allo-CSH, CHRU, Lille, France.
authors.forename: I
authors.initials: I
authors.lastname: Yakoub-Agha
authors.affiliation: Nottingham City Hospital, Nottingham, UK.
authors.forename: N H
authors.initials: NH
authors.lastname: Russell
authors.affiliation: Department of Medicine-Hematology, Oncology, University of Freiburg, Freiburg, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Finke
authors.affiliation: Department of Hematology, University Hospital Gasthuisberg, Leuven, Belgium.
authors.forename: H
authors.initials: H
authors.lastname: Schoemans
authors.affiliation: Institute of Hematology and Blood Transfusion, Prague, Czech Republic.
authors.forename: A
authors.initials: A
authors.lastname: Vitek
authors.affiliation: Hospital Clinic, Institute of Hematology and Oncology, Department of Hematology, Barcelona, Spain.
authors.forename: Á
authors.initials: Á
authors.lastname: Urbano-Ispízua
authors.affiliation: Programme de Transplantation and Therapie Cellulaire, Centre de Recherche en Cancérologie de Marseille, Institut Paoli Calmettes, Marseille, France.
authors.forename: D
authors.initials: D
authors.lastname: Blaise
authors.affiliation: Stem Cell Transplantation Unit, Helsinki University Hospital Comprehensive Cancer Center, Helsinki, Finland.
authors.forename: L
authors.initials: L
authors.lastname: Volin
authors.affiliation: Department D'Hematologie, CHU Nantes, Nantes, France.
authors.forename: P
authors.initials: P
authors.lastname: Chevallier
authors.affiliation: Servicio de Hematología, Hospital Clínico, Salamanca, Spain.
authors.forename: D
authors.initials: D
authors.lastname: Caballero
authors.affiliation: Department of Medical Statistics and Bioinformatics, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: H
authors.initials: H
authors.lastname: Putter
authors.affiliation: Department of Medical Statistics and Bioinformatics, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: van Biezen
authors.affiliation: Department of Medical Statistics and Bioinformatics, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: Henseler
authors.affiliation: Medizinische Klinik und Poliklinik V, University of Heidelberg, Heidelberg, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Schönland
authors.affiliation: Bone Marrow Transplantation Center, University Hospital Eppendorf, Hamburg, Germany.
authors.forename: N
authors.initials: N
authors.lastname: Kröger
authors.affiliation: DKMS, gemeinnützige GmbH, Tübingen, Germany.|Medizinische Klinik und Poliklinik I, Universitätsklinikum Dresden, Technische Universität Dresden, Dresden, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Schetelig
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D064591:Allografts; D002648:Child; D018572:Disease-Free Survival; D005060:Europe / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012955:Societies, Medical; D015996:Survival Rate; D013997:Time Factors