Reduced non-relapse mortality after reduced intensity conditioning in advanced chronic lymphocytic leukemia

Ann Hematol. 2002:81 Suppl 2:S47-8.

Abstract

We studied in 30 patients with progressive or relapsing chronic lymphocytic leukemia (CLL) if hematopoietic stem cell transplantation (HSCT) after conditioning with fludarabine, busulfan and ATG is effective and if treatment related mortality can be reduced compared to myeloablative conditioning regimens. Patients had 15 matched related and 15 matched unrelated donors. Graft-versus-host disease (GVHD) prophylaxis consisted of cyclosporine alone or a combination with "short course" methotrexate or mycophenolate mofetil. The median follow-up is 24 months. At last follow up 11 patients were in complete and 13 in partial remission. Six patients had stable or progressive disease. Late complete remissions occurred up to one year after transplantation and the number of patients with CR is still increasing. Four patients died due to treatment related complications resulting in a probability of treatment-related mortality of 15% (CI 95%, 1% to 29%) at 2 years. The probability of overall survival and progression free survival at two years was 79% and 61%, respectively. In conclusion, HSCT after reduced conditioning may lower the treatment-related toxicity and has the capacity to induce complete remissions.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Busulfan / administration & dosage
  • Graft vs Host Disease / epidemiology
  • Graft vs Host Disease / prevention & control
  • Hematopoietic Stem Cell Transplantation / mortality*
  • Humans
  • Immunosuppressive Agents / administration & dosage
  • Leukemia, Lymphocytic, Chronic, B-Cell / mortality*
  • Recurrence
  • Remission Induction
  • Survival Rate
  • Transplantation Conditioning / adverse effects*
  • Transplantation Conditioning / methods*
  • Vidarabine / administration & dosage
  • Vidarabine / analogs & derivatives*

Substances

  • Immunosuppressive Agents
  • Vidarabine
  • Busulfan
  • fludarabine