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Nonmyeloablative allogeneic stem cell transplantation for chronic lymphocytic leukaemia offers the possibility of disease control with minimal morbidity and mortality—a single institution experience

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Abstract

Allogeneic stem cell transplantation is a treatment option for patients with poor risk CLL. We conducted a retrospective analysis of all CLL patients allografted at our institution, the University Hospital of Cologne, Germany. Data was collected on 40 patients from 2004 to 2012. The mean age was 54, and the majority were male (75 %). On average, the patients were diagnosed 6 years (range 2–12) prior to transplant with an average of 4 years (range 1–8) from time of first-line therapy to transplant. The remission states at the time of transplant were complete remission (CR) (n = 4), stable disease (n = 10), partial remission (n = 20) and progressive disease (n = 6). Only reduced intensity conditioning regimens were employed. The average CD34+ cell dose was 4.16 × 106/kg. Neutrophil engraftment was seen by day +17 (range 10–23) post-transplant, and 88 % achieved 95–100 % donor chimerism by day 100. Overall survival, progression-free survival and non-relapse mortality at 2 years post-transplant were 65, 52.5 and 27.5 %, respectively. A total of 51 % of patients were found to be minimal residual disease (MRD)-negative at 1 year post-transplant. Our single-centre experience confirms the valuable role of allogeneic stem cell transplantation (allo-SCT) in the treatment of poor risk CLL patients with promising long-term survival and acceptable transplant-related mortality. The advent of newer therapeutic agents should not hinder the consideration of allo-SCT for this patient cohort as it remains the only curative option for these patients.

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Conflict of interest

We disclose no financial relationship with a company that has a direct financial interest in the subject matter or products discussed in the submitted manuscript, or with a company that produces a competing product. The authors declare no conflicting financial interests.

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Authors and Affiliations

  1. Stem Cell Transplantation Program, Department of Internal Medicine, University Hospital of Cologne, Cologne, Germany

    G. Chakupurakal, S. Leitzke, U. Holtick, A. Shimabukuro-Vornhagen, S. Theurich, J. Chemnitz, M. Hallek, M. von Bergwelt-Baildon & C. Scheid

  2. German Chronic Lymphocytic Leukaemia Study Group (GCLLSG), Department of Internal Medicine, University Hospital of Cologne, Cologne, Germany

    G. Chakupurakal, P. Langerbeins & M. Hallek

  3. Hematological Diagnostics, Department of Internal Medicine, University Hospital of Cologne, Cologne, Germany

    J. Schiller

  4. Institute of Legal Medicine, University Hospital of Cologne, Cologne, Germany

    P. M. Schneider

Authors
  1. G. Chakupurakal
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  2. S. Leitzke
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  3. P. Langerbeins
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  4. J. Schiller
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  5. P. M. Schneider
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  6. U. Holtick
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  7. A. Shimabukuro-Vornhagen
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  8. S. Theurich
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  9. J. Chemnitz
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  10. M. Hallek
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  11. M. von Bergwelt-Baildon
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  12. C. Scheid
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Corresponding author

Correspondence to G. Chakupurakal.

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We confirm that this article is not under consideration for publication elsewhere, that its publication is approved by all authors and tacitly or explicitly by the responsible authorities where the work was carried out, and that, if accepted, it will not be published elsewhere including electronically in the same form, in English or in any other language, without the written consent of the copyright-holder.

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Supplementary figure I

PFS of CLL patients with active disease (SD+ PD) versus those without active disease (CR+ PR) at 2 years post transplant. SD = stable disease, PD = progressive disease, CR = complete remission, PR = partial remission. (JPEG 65.6 kb)

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Chakupurakal, G., Leitzke, S., Langerbeins, P. et al. Nonmyeloablative allogeneic stem cell transplantation for chronic lymphocytic leukaemia offers the possibility of disease control with minimal morbidity and mortality—a single institution experience. Ann Hematol 94, 1717–1725 (2015). https://doi.org/10.1007/s00277-015-2449-1

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