Risk factors for treatment failure after allogeneic transplantation of patients with CLL: a report from the European Society for Blood and Marrow Transplantation

J Schetelig, L C de Wreede, M van Gelder, N S Andersen, C Moreno, A Vitek, M Karas, M Michallet, M Machaczka, M Gramatzki, D Beelen, J Finke, J Delgado, L Volin, J Passweg, P Dreger, A Henseler, A van Biezen, M Bornhäuser, S O SchönlandN Kröger

    33 Citations (Scopus)

    Abstract

    For young patients with high-risk CLL, BTK-/PI3K-inhibitors or allogeneic stem cell transplantation (alloHCT) are considered. Patients with a low risk of non-relapse mortality (NRM) but a high risk of failure of targeted therapy may benefit most from alloHCT. We performed Cox regression analyses to identify risk factors for 2-year NRM and 5-year event-free survival (using EFS as a surrogate for long-term disease control) in a large, updated EBMT registry cohort (n= 694). For the whole cohort, 2-year NRM was 28% and 5-year EFS 37%. Higher age, lower performance status, unrelated donor type and unfavorable sex-mismatch had a significant adverse impact on 2-year NRM. Two-year NRM was calculated for good- and poor-risk reference patients. Predicted 2-year-NRM was 11 and 12% for male and female good-risk patients compared with 42 and 33% for male and female poor-risk patients. For 5-year EFS, age, performance status, prior autologous HCT, remission status and sex-mismatch had a significant impact, whereas del(17p) did not. The model-based prediction of 5-year EFS was 55% and 64%, respectively, for male and female good-risk patients. Good-risk transplant candidates with high-risk CLL and limited prognosis either on or after failure of targeted therapy should still be considered for alloHCT.

    Original languageEnglish
    JournalBone Marrow Transplantation
    Volume52
    Issue number4
    Pages (from-to)552-560
    Number of pages9
    ISSN0268-3369
    DOIs
    Publication statusPublished - Apr 2017

    Keywords

    • Journal Article

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