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. Bornhauser, D. Niederwieser, M. Karas, N. S. Anderson, M. Gramatzki, P. Dreger, M. Michallet, E. Petersen, D. Bunjes, M. Potter, D. Beelen, J. J. Cornelissen, I. Yakoub-Agha, N. H. Russell, J. Finke, H. Schoemans, A. Vitek, A. Urbano-IspizuaD. Blaise, L. Volin, P. Chevallier, D. Caballero, H. Putter, A. van Biezen, A. Henseler, S. Schonland, N. Kroger, J. Schetelig

Research output: Contribution to journalArticle

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
Externally publishedYes

Keywords

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Allografts
  • Child
  • Disease-Free Survival
  • Europe/epidemiology
  • Female
  • Follow-Up Studies
  • Hematopoietic Stem Cell Transplantation
  • Humans
  • Leukemia, Lymphocytic, Chronic, B-Cell/mortality/therapy
  • Male
  • Middle Aged
  • Societies, Medical
  • Survival Rate
  • Time Factors

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  • Cite this

    Gelder, M. V., Wreede, L. C. D., Bornhauser, M., Niederwieser, D., Karas, M., Anderson, N. S., Gramatzki, M., Dreger, P., Michallet, M., Petersen, E., Bunjes, D., Potter, M., Beelen, D., Cornelissen, J. J., Yakoub-Agha, I., Russell, N. H., Finke, J., Schoemans, H., Vitek, A., ... Schetelig, J. (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 [doi]