Allogeneic HSCT may prolong DFS in 17p-del CLL

Allogeneic hematopoietic stem-cell transplantation may induce long-term disease-free survival in patients with 17p-deletion chronic lymphocytic leukemia, according to a retrospective analysis.

Because HSCT has demonstrated efficacy among patients with advanced CLL, the researchers hypothesized that it could be effective for patients with 17p-deletion CLL, which is associated with dismal prognosis.

The researchers referred to the European Group for Blood and Marrow Transplantation for baseline data on 44 patients with 17p-deletion CLL. They used a questionnaire for information on disease course and follow-up. Prior to transplantation, patients received a median of three lines of chemotherapy. Subsequently, 24 patients underwent HSCT from a matched sibling, and 20 received stem cells from an alternative donor.

At the time of HSCT, 53% of patients were in remission. Reduced-intensity conditioning was applied in 89% of patients. Grade-2 to -4 graft-versus-host disease occurred in 43% of patients and extensive chronic GVH disease occurred in 53% of patients. The researchers observed a significantly decreased incidence of relapse or progression in patients with acute or chronic GVH disease compared with patients who did not have clinical signs of GVH disease after HSCT (RR=0.2; P=.006). Different types of GVH disease prophylaxis may have an impact on the outcome of allogeneic HSCT.

At last follow-up, 19 patients were alive, with a median observation time of 39 months. Three-year OS was 44%, and PFS was 37%.

J Clin Oncol. 2008;26:5094-5100.