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

Lookup NU author(s): Professor Matthew CollinORCiD

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Abstract

© 2017 Macmillan Publishers Limited, part of Springer Nature. 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.

Publication metadata

Author(s): Van Gelder M, De Wreede LC, Bornhauser 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-Ispizua A, Blaise D, Volin L, Chevallier P, Caballero D, Putter H, Van Biezen A, Henseler A, Schonland S, Kroger N, Schetelig J, on behalf of the Chronic Malignancy Working Party

Publication type: Article

Publication status: Published

Journal: Bone Marrow Transplantation

Year: 2017

Volume: 52

Issue: 3

Pages: 372-380

Print publication date: 01/03/2017

Online publication date: 12/12/2016

Acceptance date: 02/08/2016

ISSN (print): 0268-3369

ISSN (electronic): 1476-5365

Publisher: Nature Publishing Group

URL: https://doi.org/10.1038/bmt.2016.282

DOI: 10.1038/bmt.2016.282

Notes: Matthew Collin = member of the Chronic Malignancy Working Party

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