Long-term survival of patients with CLL after allogeneic transplantation: A report from the European Society for Blood and Marrow Transplantation

M. Van Gelder, L. C. De Wreede, M. Bornhäuser, Dietger Niederwieser, M. Karas, N. S. Anderson, Martin Gramatzki, P. Dreger, M. Michallet, E. Petersen, D. Bunjes, M. Potter, Dietrich Beelen, J. J. Cornelissen, Ibrahim Yakoub-Agha, N. H. Russell, J. Finke, H. Schoemans, A. Vitek, Urbano-IspízuaD. Blaise, Liisa Volin, Patrice Chevallier, Dolores Caballero, H. Putter, A. Van Biezen, A. Henseler, S. Schönland, Nicolaus Kröger, J. Schetelig, Gerhard Ehninger, Dietger Niederwieser, Pavel Jindra, Henrik Sengeloev, Martin Gramatzki, Peter Dreger, Eefke Petersen, Donald Bunjes, Michael Potter, Andrea Bacigalupo, Agostino Cortelezzi, Paolo Corradini, Fabio Ciceri, Attilio Olivieri, Giovanni Martinelli, Emilio Paolo Alessandrino, Luca Castagna, Nicola Cascavilla, Angelo Michele Carella, Gian Antonia Da Prada, Chronic Malignancy Working Party

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Even with the availability of targeted drugs, allogeneic hematopoietic cell transplantation (allo-HCT) is the only therapy with curative potential for patients with CLL. Cure can be assessed by comparing long-term survival of patients to the matched general population. Using data from 2589 patients who received allo-HCT between 2000 and 2010, we used landmark analyses and methods from relative survival analysis to calculate excess mortality compared with an age-, sex- and calendar year-matched general population. Estimated event-free survival, overall survival and non-relapse mortality (NRM) 10 years after allo-HCT were 28% (95% confidence interval (CI), 25-31), 35% (95% CI, 32-38) and 40% (95% CI, 37-42), respectively. Patients who passed the 5-year landmark event-free survival (N=394) had a 79% probability (95% CI, 73-85) of surviving the subsequent 5 years without an event. Relapse and NRM contributed equally to treatment failure. Five-year mortality for 45- and 65-year-old reference patients who were event-free at the 5-year landmark was 8% and 47% compared with 3% and 14% in the matched general population, respectively. The prospect of long-term disease-free survival remains an argument to consider allo-HCT for young patients with high-risk CLL, and programs to understand and prevent late causes of failure for long-term survivors are warranted, especially for older patients.

Original languageEnglish
Pages (from-to)372-380
Number of pages9
JournalBone Marrow Transplantation
Volume52
Issue number3
DOIs
Publication statusPublished - Mar 1 2017

Fingerprint

Homologous Transplantation
Transplantation
Bone Marrow
Cell Transplantation
Survival
Confidence Intervals
Disease-Free Survival
Mortality
Population
Survival Analysis
Treatment Failure
Survivors
Recurrence
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Van Gelder, M., De Wreede, L. C., Bornhäuser, M., Niederwieser, D., Karas, M., Anderson, N. S., ... Chronic Malignancy Working Party (2017). Long-term survival of patients with CLL after allogeneic transplantation: A report from the European Society for Blood and Marrow Transplantation. Bone Marrow Transplantation, 52(3), 372-380. https://doi.org/10.1038/bmt.2016.282

Long-term survival of patients with CLL after allogeneic transplantation : A report from the European Society for Blood and Marrow Transplantation. / Van Gelder, M.; De Wreede, L. C.; Bornhäuser, M.; Niederwieser, Dietger; Karas, M.; Anderson, N. S.; Gramatzki, Martin; Dreger, P.; Michallet, M.; Petersen, E.; Bunjes, D.; Potter, M.; Beelen, Dietrich; Cornelissen, J. J.; Yakoub-Agha, Ibrahim; Russell, N. H.; Finke, J.; Schoemans, H.; Vitek, A.; Urbano-Ispízua; Blaise, D.; Volin, Liisa; Chevallier, Patrice; Caballero, Dolores; Putter, H.; Van Biezen, A.; Henseler, A.; Schönland, S.; Kröger, Nicolaus; Schetelig, J.; Ehninger, Gerhard; Niederwieser, Dietger; Jindra, Pavel; Sengeloev, Henrik; Gramatzki, Martin; Dreger, Peter; Petersen, Eefke; Bunjes, Donald; Potter, Michael; Bacigalupo, Andrea; Cortelezzi, Agostino; Corradini, Paolo; Ciceri, Fabio; Olivieri, Attilio; Martinelli, Giovanni; Alessandrino, Emilio Paolo; Castagna, Luca; Cascavilla, Nicola; Carella, Angelo Michele; Da Prada, Gian Antonia; Chronic Malignancy Working Party.

In: Bone Marrow Transplantation, Vol. 52, No. 3, 01.03.2017, p. 372-380.

Research output: Contribution to journalArticle

Van Gelder, M, De Wreede, LC, Bornhäuser, M, Niederwieser, D, Karas, M, Anderson, NS, Gramatzki, M, Dreger, P, Michallet, M, Petersen, E, Bunjes, D, Potter, M, Beelen, D, Cornelissen, JJ, Yakoub-Agha, I, Russell, NH, Finke, J, Schoemans, H, Vitek, A, Urbano-Ispízua, Blaise, D, Volin, L, Chevallier, P, Caballero, D, Putter, H, Van Biezen, A, Henseler, A, Schönland, S, Kröger, N, Schetelig, J, Ehninger, G, Niederwieser, D, Jindra, P, Sengeloev, H, Gramatzki, M, Dreger, P, Petersen, E, Bunjes, D, Potter, M, Bacigalupo, A, Cortelezzi, A, Corradini, P, Ciceri, F, Olivieri, A, Martinelli, G, Alessandrino, EP, Castagna, L, Cascavilla, N, Carella, AM, Da Prada, GA & Chronic Malignancy Working Party 2017, 'Long-term survival of patients with CLL after allogeneic transplantation: A report from the European Society for Blood and Marrow Transplantation', Bone Marrow Transplantation, vol. 52, no. 3, pp. 372-380. https://doi.org/10.1038/bmt.2016.282
Van Gelder, M. ; De Wreede, L. C. ; Bornhäuser, M. ; Niederwieser, Dietger ; Karas, M. ; Anderson, N. S. ; Gramatzki, Martin ; Dreger, P. ; Michallet, M. ; Petersen, E. ; Bunjes, D. ; Potter, M. ; Beelen, Dietrich ; Cornelissen, J. J. ; Yakoub-Agha, Ibrahim ; Russell, N. H. ; Finke, J. ; Schoemans, H. ; Vitek, A. ; Urbano-Ispízua ; Blaise, D. ; Volin, Liisa ; Chevallier, Patrice ; Caballero, Dolores ; Putter, H. ; Van Biezen, A. ; Henseler, A. ; Schönland, S. ; Kröger, Nicolaus ; Schetelig, J. ; Ehninger, Gerhard ; Niederwieser, Dietger ; Jindra, Pavel ; Sengeloev, Henrik ; Gramatzki, Martin ; Dreger, Peter ; Petersen, Eefke ; Bunjes, Donald ; Potter, Michael ; Bacigalupo, Andrea ; Cortelezzi, Agostino ; Corradini, Paolo ; Ciceri, Fabio ; Olivieri, Attilio ; Martinelli, Giovanni ; Alessandrino, Emilio Paolo ; Castagna, Luca ; Cascavilla, Nicola ; Carella, Angelo Michele ; Da Prada, Gian Antonia ; Chronic Malignancy Working Party. / Long-term survival of patients with CLL after allogeneic transplantation : A report from the European Society for Blood and Marrow Transplantation. In: Bone Marrow Transplantation. 2017 ; Vol. 52, No. 3. pp. 372-380.
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T2 - A report from the European Society for Blood and Marrow Transplantation

AU - Van Gelder, M.

AU - De Wreede, L. C.

AU - Bornhäuser, M.

AU - Niederwieser, Dietger

AU - Karas, M.

AU - Anderson, N. S.

AU - Gramatzki, Martin

AU - Dreger, P.

AU - Michallet, M.

AU - Petersen, E.

AU - Bunjes, D.

AU - Potter, M.

AU - Beelen, Dietrich

AU - Cornelissen, J. J.

AU - Yakoub-Agha, Ibrahim

AU - Russell, N. H.

AU - Finke, J.

AU - Schoemans, H.

AU - Vitek, A.

AU - Urbano-Ispízua,

AU - Blaise, D.

AU - Volin, Liisa

AU - Chevallier, Patrice

AU - Caballero, Dolores

AU - Putter, H.

AU - Van Biezen, A.

AU - Henseler, A.

AU - Schönland, S.

AU - Kröger, Nicolaus

AU - Schetelig, J.

AU - Ehninger, Gerhard

AU - Niederwieser, Dietger

AU - Jindra, Pavel

AU - Sengeloev, Henrik

AU - Gramatzki, Martin

AU - Dreger, Peter

AU - Petersen, Eefke

AU - Bunjes, Donald

AU - Potter, Michael

AU - Bacigalupo, Andrea

AU - Cortelezzi, Agostino

AU - Corradini, Paolo

AU - Ciceri, Fabio

AU - Olivieri, Attilio

AU - Martinelli, Giovanni

AU - Alessandrino, Emilio Paolo

AU - Castagna, Luca

AU - Cascavilla, Nicola

AU - Carella, Angelo Michele

AU - Da Prada, Gian Antonia

AU - Chronic Malignancy Working Party

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N2 - Even with the availability of targeted drugs, allogeneic hematopoietic cell transplantation (allo-HCT) is the only therapy with curative potential for patients with CLL. Cure can be assessed by comparing long-term survival of patients to the matched general population. Using data from 2589 patients who received allo-HCT between 2000 and 2010, we used landmark analyses and methods from relative survival analysis to calculate excess mortality compared with an age-, sex- and calendar year-matched general population. Estimated event-free survival, overall survival and non-relapse mortality (NRM) 10 years after allo-HCT were 28% (95% confidence interval (CI), 25-31), 35% (95% CI, 32-38) and 40% (95% CI, 37-42), respectively. Patients who passed the 5-year landmark event-free survival (N=394) had a 79% probability (95% CI, 73-85) of surviving the subsequent 5 years without an event. Relapse and NRM contributed equally to treatment failure. Five-year mortality for 45- and 65-year-old reference patients who were event-free at the 5-year landmark was 8% and 47% compared with 3% and 14% in the matched general population, respectively. The prospect of long-term disease-free survival remains an argument to consider allo-HCT for young patients with high-risk CLL, and programs to understand and prevent late causes of failure for long-term survivors are warranted, especially for older patients.

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