Journal Article

Long-term survival of patients with CLL after allogeneic transplantation: a report from the European Society for Blood and Marrow Transplantation

Potter, M, Vitek, A, Cornelissen, J J, Kröger, N, van Biezen, A, Caballero, D, de Wreede, L C, Gramatzki, M, Urbano-Ispízua, Á, Anderson, N S, Schetelig, J, Putter, H, Michallet, M, van Gelder, M, Yakoub-Agha, I, Schönland, S, Karas, M, Beelen, D, Blaise, D, Niederwieser, D, Russell, N H, Henseler, A, Bornhäuser, M, Dreger, P, Petersen, E, Bunjes, D, Chevallier, P, Finke, J, Volin, L, Schoemans, H

2017

Overview

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.

• Publisher: Nature Publishing Group UK,Nature Publishing Group
• Subject: 692/308/174 / 692/699/1541/1990/283/1895 / Adolescent / Adult / Age Factors / Aged / Allografts / Bone marrow / Cancer treatment / Care and treatment / Cell Biology / Child / Chronic lymphocytic leukemia / Clinical Medicine / Confidence intervals / Disease-Free Survival / Europe - epidemiology / Female / Follow-Up Studies / Hematologi / Hematology / Hematopoietic Stem Cell Transplantation / Humans / Immunosuppressive agents / Internal Medicine / Klinisk medicin / Leukemia, Lymphocytic, Chronic, B-Cell - mortality / Leukemia, Lymphocytic, Chronic, B-Cell - therapy / Male / Medical and Health Sciences / Medicin och hälsovetenskap / Medicine / Medicine & Public Health / Middle Aged / Mortality / original-article / Patient outcomes / Patients / Public Health / Societies, Medical / Statistical analysis / Stem cell transplantation / Stem Cells / Survival / Survival analysis / Survival Rate / Time Factors / Transplantation