Long-term survival of patients with CLL after allogeneic transplantation: a report from the European Society for Blood and Marrow Transplantation
Language English Country England, Great Britain Media print-electronic
Document type Clinical Trial, Journal Article, Multicenter Study
PubMed
27941763
DOI
10.1038/bmt.2016.282
PII: bmt2016282
Knihovny.cz E-resources
- MeSH
- Allografts MeSH
- Time Factors MeSH
- Leukemia, Lymphocytic, Chronic, B-Cell mortality therapy MeSH
- Child MeSH
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Survival Rate MeSH
- Adolescent MeSH
- Follow-Up Studies MeSH
- Disease-Free Survival MeSH
- Aged MeSH
- Societies, Medical MeSH
- Hematopoietic Stem Cell Transplantation * MeSH
- Age Factors MeSH
- Check Tag
- Child MeSH
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Clinical Trial MeSH
- Multicenter Study MeSH
- Geographicals
- Europe epidemiology MeSH
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 Medicine Hematology Oncology University of Freiburg Freiburg Germany
Division of Hematology Oncology and Hemostasiology University Hospital Leipzig Leipzig 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 5 University of Heidelberg Heidelberg Germany
Nottingham City Hospital Nottingham UK
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