Dreger, Peter, Doehner, Hartmut, Ritgen, Matthias, Boettcher, Sebastian, Busch, Raymonde, Dietrich, Sascha ORCID: 0000-0002-0648-1832, Bunjes, Donald, Cohen, Sandra, Schubert, Joerg, Hegenbart, Ute, Beelen, Dietrich ORCID: 0000-0001-5050-220X, Zeis, Matthias, Stadler, Michael, Hasenkamp, Justin, Uharek, Lutz, Scheid, Christof, Humpe, Andreas, Zenz, Thorsten, Winkler, Dirk, Hallek, Michael, Kneba, Michael, Schmitz, Norbert and Stilgenbauer, Stephan (2010). Allogeneic stem cell transplantation provides durable disease control in poor-risk chronic lymphocytic leukemia: long-term clinical and MRD results of the German CLL Study Group CLL3X trial. Blood, 116 (14). S. 2438 - 2448. WASHINGTON: AMER SOC HEMATOLOGY. ISSN 0006-4971

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Abstract

The purpose of this prospective multicenter phase 2 trial was to investigate the long-term outcome of reduced-intensity conditioning allogeneic stem cell transplantation (alloSCT) in patients with poor-risk chronic lymphocytic leukemia. Conditioning was fludarabine/cyclophosphamide-based. Longitudinal quantitative monitoring of minimal residual disease (MRD) was performed centrally by MRD-flow or real-time quantitative polymerase chain reaction. One hundred eligible patients were enrolled, and 90 patients proceeded to alloSCT. With a median follow-up of 46 months (7-102 months), 4-year nonrelapse mortality, event-free survival (EFS) and overall survival (OS) were 23%, 42%, and 65%, respectively. Of 52 patients with MRD monitoring available, 27 (52%) were alive and MRD negative at 12 months after transplant. Four-year EFS of this subset was 89% with all event-free patients except for 2 being MRD negative at the most recent assessment. EFS was similar for all genetic subsets, including 17p deletion (17p-). In multivariate analyses, uncontrolled disease at alloSCT and in vivo T-cell depletion with alemtuzumab, but not 17p-, previous purine analogue refractoriness, or donor source (human leukocyte antigen-identical siblings or unrelated donors) had an adverse impact on EFS and OS. In conclusion, alloSCT for poor-risk chronic lymphocytic leukemia can result in long-term MRD-negative survival in up to one-half of the patients independent of the underlying genomic risk profile. This trial is registered at http://clinicaltrials.gov as NCT00281983. (Blood. 2010;116(14):2438-2447)

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Dreger, PeterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Doehner, HartmutUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ritgen, MatthiasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Boettcher, SebastianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Busch, RaymondeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Dietrich, SaschaUNSPECIFIEDorcid.org/0000-0002-0648-1832UNSPECIFIED
Bunjes, DonaldUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Cohen, SandraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schubert, JoergUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hegenbart, UteUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Beelen, DietrichUNSPECIFIEDorcid.org/0000-0001-5050-220XUNSPECIFIED
Zeis, MatthiasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Stadler, MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hasenkamp, JustinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Uharek, LutzUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Scheid, ChristofUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Humpe, AndreasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Zenz, ThorstenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Winkler, DirkUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hallek, MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kneba, MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schmitz, NorbertUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Stilgenbauer, StephanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-494420
DOI: 10.1182/blood-2010-03-275420
Journal or Publication Title: Blood
Volume: 116
Number: 14
Page Range: S. 2438 - 2448
Date: 2010
Publisher: AMER SOC HEMATOLOGY
Place of Publication: WASHINGTON
ISSN: 0006-4971
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
GRAFT-VERSUS-LEUKEMIA; TREATMENT-RELATED MORTALITY; MINIMAL RESIDUAL DISEASE; GENE MUTATION STATUS; HEAVY-CHAIN GENE; MARROW-TRANSPLANTATION; CD38 EXPRESSION; GENOMIC ABERRATIONS; FLUDARABINE; SURVIVALMultiple languages
HematologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/49442

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