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.

BMT Unit Department of Hematology Rigshospitalet Copenhagen Denmark

Bone Marrow Transplantation Center University Hospital Eppendorf Hamburg Germany

Center Hospitalier Lyon Sud Hématologie Lyon France

Department D'Hematologie CHU Nantes Nantes France

Department of Bone Marrow Transplantation University Hospital Essen Germany

Department of Haematology University Medical Center Utrecht The Netherlands

Department of Hematology Oncology Charles University Hospital Pilsen Czech Republic

Department of Hematology University Hospital Gasthuisberg Leuven Belgium

Department of Internal Medicine Hematology University Hospital Maastricht Maastricht The Netherlands

Department of Medical Statistics and Bioinformatics Leiden University Medical Center Leiden The Netherlands

Department of Medicine Hematology Oncology University of Freiburg Freiburg Germany

Division of Hematology Oncology and Hemostasiology University Hospital Leipzig Leipzig Germany

Division of Stem Cell Transplantation and Immunotherapy University Hospital Schleswig Holstein Kiel Germany

DKMS gemeinnützige GmbH Tübingen Germany

Erasmus MC Daniel den Hoed Cancer Center Rotterdam The Netherlands

Hôpital HURIEZ UAM allo CSH CHRU Lille France

Hospital Clinic Institute of Hematology and Oncology Department of Hematology Barcelona Spain

Institute of Hematology and Blood Transfusion Prague Czech Republic

Klinik fuer Innere Medizin 3 Universitätsklinikum Ulm Ulm Germany

Leukaemia Myeloma Units Royal Marsden Hospital London Surrey UK

Medizinische Klinik und Poliklinik 1 Universitätsklinikum Dresden Technische Universität Dresden Dresden Germany

Medizinische Klinik und Poliklinik 5 University of Heidelberg Heidelberg Germany

Nottingham City Hospital Nottingham UK

Programme de Transplantation and Therapie Cellulaire Centre de Recherche en Cancérologie de Marseille Institut Paoli Calmettes Marseille France

Servicio de Hematología Hospital Clínico Salamanca Spain

Stem Cell Transplantation Unit Helsinki University Hospital Comprehensive Cancer Center Helsinki Finland

Citace poskytuje Crossref.org

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