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Allografting for indolent lymphoid neoplasms
C L Toze1, J D Shepherd, J M Connors
1Division of Hematology, Vancouver Hospital & Health Sciences Centre, Canada.
Summary
Allogeneic bone marrow transplantation (BMT) offers a feasible strategy for achieving long-term disease-free survival in young patients with advanced low-grade lymphoma (LGL) and chronic lymphocytic leukemia (CLL). This approach shows promising results for eligible patients.
Area of Science:
- Hematology
- Oncology
- Transplantation Medicine
Background:
- Allogeneic bone marrow transplantation (BMT) is explored for low-grade lymphoma (LGL) and chronic lymphocytic leukemia (CLL).
- The primary goal is to achieve long-term disease-free survival in patients with these hematologic malignancies.
Purpose of the Study:
- To evaluate the feasibility and outcomes of allogeneic BMT in young patients with advanced stage LGL and CLL.
- To assess the potential for long-term disease control and survival following BMT.
Main Methods:
- Twenty-nine patients (19 LGL, 10 CLL) received allogeneic BMT between 1995-1999.
- Most patients (79%) had advanced stage (Ann Arbor or Rai stage IV) and 83% had not achieved complete remission (CR) prior to transplant.
- Donor sources included HLA-matched siblings, unrelated donors, and syngeneic donors.
Main Results:
- At a median follow-up of 29 months, 17 patients were alive with a good performance status (median KPS 90%).
- 85% of evaluable patients achieved complete remission (CR) post-BMT.
- Overall survival was 51% and event-free survival was 44%, with transplant-related deaths in 8 patients and disease-related deaths in 4.
Conclusions:
- Allogeneic BMT is a feasible strategy for selected young patients with advanced LGL or CLL.
- This approach can lead to long-term disease-free survival for patients with these conditions.