Risk factors for treatment failure after allogeneic transplantation of patients with CLL: a report from the European Society for Blood and Marrow Transplantation

J. Schetelig*, L. C. de Wreede, M. van Gelder, N. S. Andersen, C. Moreno, A. Vitek, M. Karas, M. Michallet, M. Machaczka, M. Gramatzki, D. Beelen, J. Finke, J. Delgado, L. Volin, J. Passweg, P. Dreger, A. Henseler, A. van Biezen, M. Bornhaeuser, S. O. SchoenlandN. Kroeger, CLL Subcomm, Chronic Malignancies Working Party

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

24 Citations (Web of Science)

Abstract

For young patients with high-risk CLL, BTK-/PI3K-inhibitors or allogeneic stem cell transplantation (alloHCT) are considered. Patients with a low risk of non-relapse mortality (NRM) but a high risk of failure of targeted therapy may benefit most from alloHCT. We performed Cox regression analyses to identify risk factors for 2-year NRM and 5-year event-free survival (using EFS as a surrogate for long-term disease control) in a large, updated EBMT registry cohort (n = 694). For the whole cohort, 2-year NRM was 28% and 5-year EFS 37%. Higher age, lower performance status, unrelated donor type and unfavorable sex-mismatch had a significant adverse impact on 2-year NRM. Two-year NRM was calculated for good-and poor-risk reference patients. Predicted 2-year-NRM was 11 and 12% for male and female good-risk patients compared with 42 and 33% for male and female poor-risk patients. For 5-year EFS, age, performance status, prior autologous HCT, remission status and sex-mismatch had a significant impact, whereas del(17p) did not. The model-based prediction of 5-year EFS was 55% and 64%, respectively, for male and female good-risk patients. Good-risk transplant candidates with high-risk CLL and limited prognosis either on or after failure of targeted therapy should still be considered for alloHCT.

Original languageEnglish
Pages (from-to)552-560
Number of pages9
JournalBone Marrow Transplantation
Volume52
Issue number4
DOIs
Publication statusPublished - Apr 2017

Keywords

  • CHRONIC LYMPHOCYTIC-LEUKEMIA
  • STEM-CELL TRANSPLANTATION
  • RETROSPECTIVE ANALYSIS
  • FOLLOW-UP
  • IBRUTINIB
  • SURVIVAL
  • DISEASE
  • VENETOCLAX
  • MECHANISMS
  • IDELALISIB

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