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Published on: December 8, 2023
Allogeneic Stem Cell Transplantation-A Salvage Option for High-Risk Chronic Lymphocytic Leukemia Patients: A 15-Year
Natalia B Mikhailova1, Maria I Kislova2, Maria O Ivanova1
1R.M.Gorbacheva Research Institute, Pavlov University, Saint-Petersburg, Russia.
Insights
Allogeneic hematopoietic cell transplantation (alloSCT) is still a vital option for high-risk chronic lymphocytic leukemia (CLL) patients. Recent data show alloSCT is now a safer procedure, offering durable responses for select CLL cases.
Area of Science:
- Hematology
- Oncology
- Immunology
Background:
- Allogeneic hematopoietic cell transplantation (alloSCT) use in chronic lymphocytic leukemia (CLL) has declined with new targeted therapies.
- However, alloSCT remains a crucial option for heavily pretreated or high-risk CLL patients lacking other treatment alternatives.
Purpose of the Study:
- To evaluate the safety and efficacy of allogeneic hematopoietic cell transplantation (alloSCT) in chronic lymphocytic leukemia (CLL) patients.
- To determine the optimal timing for alloSCT in the context of emerging targeted therapies like Bruton's tyrosine kinase inhibitors and BCL-2 inhibitors.
Main Methods:
- Retrospective analysis of 44 chronic lymphocytic leukemia (CLL) patients who underwent allogeneic hematopoietic cell transplantation (alloSCT) between 2006 and 2023.
- Evaluation of progression-free survival (PFS), overall survival (OS), and graft-versus-host disease relapse-free survival (GRFS).
Main Results:
- Progression-free survival rates were 79.2% at 12 months and 69.3% at 24 months.
- Overall survival rates were 81.4% at 12 months and 74% at 24 months.
- Graft-versus-host disease relapse-free survival was 57%.
Conclusions:
- Despite a small sample size, this study indicates that allogeneic hematopoietic cell transplantation (alloSCT) has become a significantly safer procedure for chronic lymphocytic leukemia (CLL) patients.
- AlloSCT continues to be an important therapeutic option for specific high-risk or heavily pretreated CLL populations.
Abstract:
The role of allogeneic hematopoietic cell transplantation (alloSCT) in chronic lymphocytic leukemia (CLL) has decreased in recent years due to the emergence of new effective targeted agents for the treatment of this disease. However, for a certain group of heavily pretreated or high-risk CLL patients with no other therapeutic options, allo-SCT remains important. Due to the fact that in most high-risk CLL patients it is possible to achieve durable response as a result of Bruton's tyrosine kinase inhibitors (ВТК), BCL-2 inhibitor and especially in their combined application, including in the first line of therapy, the choice of time point for alloSCT becomes relevant. In this retrospective study allo-SCT was performed in 44 patients with the period from 2006 to 2023. Progression-free survival was 79.2% at 12 months and 69.3% at 24 months. Similarly, overall survival was 81.4% at 12 months and 74% at 24 months. Graft-versus-host disease relapse-free survival was 57%. Despite small sample size, our study demonstrates that alloSCT has become a significantly safer procedure in patients with CLL.
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