Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2005 Dec 15;106(13):4389-96.
doi: 10.1182/blood-2005-05-1778. Epub 2005 Aug 30.

Autologous and allogeneic stem cell transplantations for poor-risk chronic lymphocytic leukemia

John G Gribben  1 , David Zahrieh, Katherine Stephans, Lini Bartlett-Pandite, Edwin P Alyea, David C Fisher, Arnold S Freedman, Peter Mauch, Robert Schlossman, Lecia V Sequist, Robert J Soiffer, Blossom Marshall, Donna Neuberg, Jerome Ritz, Lee M Nadler
Affiliations
Clinical Trial

Autologous and allogeneic stem cell transplantations for poor-risk chronic lymphocytic leukemia

John G Gribben et al. Blood. .

Abstract

We report here on the long-term follow-up on 162 patients with high-risk chronic lymphocytic leukemia (CLL) who have undergone hematopoietic stem cell transplantation (SCT) at a single center from 1989 to 1999. Twenty-five patients with human leukocyte antigen (HLA)-matched sibling donors underwent T-cell-depleted allogeneic SCT, and 137 patients without HLA-matched sibling donors underwent autologous SCT. The 100-day mortality was 4% for both groups, but later morbidity and mortality were negatively affected on outcome. Progression-free survival was significantly longer following autologous than allogeneic SCT, but there was no difference in overall survival and no difference in the cumulative incidence of disease recurrence or deaths without recurrence between the 2 groups. At a median follow-up of 6.5 years there is no evidence of a plateau of progression-free survival. The majority of patients treated with donor lymphocyte infusions after relapse responded, demonstrating a significant graft-versus-leukemia effect in CLL. From these findings we have altered our approach for patients with high-risk CLL and are currently exploring the role of related and unrelated allogeneic SCT following reduced-intensity conditioning regimens.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Overall survival after autologous and allogeneic stem cell transplantations.
Figure 2.
Figure 2.
Cumulative incidence of disease progression and death without disease progression after autologous and allogeneic stem cell transplantations.
Figure 3.
Figure 3.
Progression-free survival after autologous and allogeneic stem cell transplantations.
Figure 4.
Figure 4.
Assessment of disease burden after TCD allogeneic SCT and after DLI in a patient with CLL. Real-time quantitative PCR analysis of the CLL-specific IgH rearrangement was performed on BM samples obtained serially from this patient at the times shown following allogeneic SCT and following DLI.
Figure 5.
Figure 5.
Outcome after autologous and allogeneic stem cell transplantations by time of transplantation (protocol 89-039 from 1989 to 1994; protocol 94-055 from 1995). (A) Progression-free survival. Tx indicates treatment. (B) Overall survival.
Figure 6.
Figure 6.
Outcome after transplantation by immunoglobulin heavy chain gene mutational status. (A) Progression-free survival. (B) Overall survival.
Figure 7.
Figure 7.
Cumulative incidence of MDS and death after autologous stem cell transplantation.
See this image and copyright information in PMC

References

    1. Rai KR, Peterson BL, Appelbaum FR, et al. Fludarabine compared with chlorambucil as primary therapy for chronic lymphocytic leukemia. N Engl J Med. 2000;343: 1750-1757. - PubMed
    1. Rabinowe SN, Soiffer RJ, Gribben JG, et al. Autologous and allogeneic bone marrow transplantation for poor prognosis patients with B-cell chronic lymphocytic leukemia. Blood. 1993;82: 1366-1376. - PubMed
    1. Khouri IF, Keating MJ, Vriesendorp HM, et al. Autologous and allogeneic bone marrow transplantation for chronic lymphocytic leukemia: preliminary results. J Clin Oncol. 1994;12: 748-758. - PubMed
    1. Michallet M, Archimbaud E, Bandini G, et al. HLA-identical sibling bone marrow transplantation in younger patients with chronic lymphocytic leukemia. European Group for blood and marrow transplantation and the International bone marrow transplant registry. Ann Internal Med. 1996;124: 311-315. - PubMed
    1. Dreger P, von Neuhoff N, Kuse R, et al. Early stem cell transplantation for chronic lymphocytic leukaemia: a chance for cure? Br J Cancer. 1998;77: 2291-2297. - PMC - PubMed

Publication types

Substances