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Allogeneic hematopoietic cell transplantation after prior targeted therapy for high-risk chronic lymphocytic leukemia.
Kim, Haesook T; Shaughnessy, Conner J; Rai, Sharmila C; Reynolds, Carol; Ho, Vincent T; Cutler, Corey; Koreth, John; Gooptu, Mahasweta; Romee, Rizwan; Nikiforow, Sarah; Armand, Philippe; Alyea, Edwin P; Antin, Joseph H; Wu, Catherine J; Soiffer, Robert J; Ritz, Jerome; Brown, Jennifer R.
Afiliación
  • Kim HT; Department of Data Sciences, Dana-Farber Cancer Institute, Harvard School of Public Health, Boston, MA; and.
  • Shaughnessy CJ; Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA.
  • Rai SC; Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA.
  • Reynolds C; Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA.
  • Ho VT; Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA.
  • Cutler C; Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA.
  • Koreth J; Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA.
  • Gooptu M; Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA.
  • Romee R; Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA.
  • Nikiforow S; Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA.
  • Armand P; Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA.
  • Alyea EP; Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA.
  • Antin JH; Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA.
  • Wu CJ; Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA.
  • Soiffer RJ; Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA.
  • Ritz J; Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA.
  • Brown JR; Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA.
Blood Adv ; 4(17): 4113-4123, 2020 09 08.
Article en En | MEDLINE | ID: mdl-32882002
Allogeneic hematopoietic cell transplantation (alloHCT) can cure previously treated high-risk chronic lymphocytic leukemia (CLL) patients if they are suitable for transplant through the graft-versus-leukemia effect. However, since the emergence of targeted therapies, the role of alloHCT for high-risk CLL is less clear. To address this question, we evaluated 108 high-risk CLL patients who underwent alloHCT from 2010 to 2018. Thirty patients from the period of 2013 to 2018 received targeted therapy prior to alloHCT. The median age for the targeted therapy cohort was 60 years (range, 30-71 years), and 20% and 73% had complete and partial remission, respectively: 76% had del(17p), 46.2% had 5 or more cytogenetic abnormalities, and 78.9% were IGHV unmutated. The median number of prior therapies was 4 (range, 1-9). With a median follow-up time of 36 months (range, 10-72 months), the 3-year overall (OS) and progression-free survival (PFS) were 87% and 69%, respectively. The 3-year cumulative incidence of nonrelapse mortality and relapse was 7% and 24%, respectively. For the control cohort of 78 patients who underwent alloHCT from 2010 to 2014 and received only chemoimmunotherapy prior to transplant, the 3-year OS and PFS were 69% and 58%, respectively. Patients treated with targeted therapy prior to alloHCT had a significantly higher number of circulating T and B cells and a lower ratio of CD4 regulatory T cells to CD4 conventional T cells early after transplant. In summary, despite multiple high-risk features, the clinical outcome of CLL patients who receive targeted therapy prior to transplant is excellent and alloHCT should be offered while the disease is under control.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Leucemia Linfocítica Crónica de Células B / Trasplante de Células Madre Hematopoyéticas Tipo de estudio: Etiology_studies / Risk_factors_studies Límite: Adult / Aged / Humans / Middle aged Idioma: En Revista: Blood Adv Año: 2020 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Leucemia Linfocítica Crónica de Células B / Trasplante de Células Madre Hematopoyéticas Tipo de estudio: Etiology_studies / Risk_factors_studies Límite: Adult / Aged / Humans / Middle aged Idioma: En Revista: Blood Adv Año: 2020 Tipo del documento: Article Pais de publicación: Estados Unidos