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Where Does Allogeneic Stem Cell Transplantation Fit in the Treatment of Chronic Lymphocytic Leukemia?

  • Chronic Lymphocytic Leukemias (S O’Brien, Section Editor)
  • Published:
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Abstract

Allogeneic hematopoietic stem cell transplantation (alloHSCT) has been considered as the treatment of choice for patients with high-risk chronic lymphocytic leukemia (CLL) (i.e., refractory to purine analogs, short response (<24 months) to intensive treatments, and/or presence of 17p/TP53 abnormalities). Currently, new and highly effective therapeutic agents targeting BCR-mediated intracellular signal transduction have been incorporated into the CLL treatment armamentarium. These signal transduction inhibitors (STI) will change the algorithms of high-risk CLL (HR-CLL) management. Despite the limited body of evidence, there is sufficient rationale for withholding alloHSCT in patients with 17p-/TP53mut CLL in first remission. In contrast, the perspectives of patients with relapsed 17p-/TP53mut CLL remain uncertain even if responding to STI. The same accounts for patients with HR-CLL progressing under STI. In both scenarios, it is reasonable to consider alloHSCT, ideally after response to alternative STI regimens.

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Conflict of Interest

Dr. Peter Dreger is a board member for the European Society for Blood and Marrow Transplantation. He reports personal fees from Janssen, Gilead, and GSK.

Dr. Emili Montserrat declares no potential conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Department Medicine V, University of Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany

    Peter Dreger

  2. EBMT Lymphoma Working Party, Paris, France

    Peter Dreger

  3. Department of Hematology, Hospital Clínic, University of Barcelona, Barcelona, Spain

    Emili Montserrat

  4. ERIC Hospital Clínic, Barcelona, Spain

    Emili Montserrat

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  1. Peter Dreger
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on behalf of the European Society for Blood and Marrow Transplantation (EBMT) and the European Research Initiative on CLL (ERIC)

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Correspondence to Peter Dreger.

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This article is part of the Topical Collection on Chronic Lymphocytic Leukemias

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Dreger, P., Montserrat, E. & on behalf of the European Society for Blood and Marrow Transplantation (EBMT) and the European Research Initiative on CLL (ERIC). Where Does Allogeneic Stem Cell Transplantation Fit in the Treatment of Chronic Lymphocytic Leukemia?. Curr Hematol Malig Rep 10, 59–64 (2015). https://doi.org/10.1007/s11899-014-0242-1

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  • DOI: https://doi.org/10.1007/s11899-014-0242-1

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