Long-term follow-up for RIC allogeneic SCT in CLL
| . | Sorror et al* . | Dreger et al† . | Brown et al‡ . | Khouri et al§ . |
|---|---|---|---|---|
| No. of patients | 82 (n = 64 with 5-y follow-up) | 90 | 76 | 86 |
| Median follow-up | 5 y | 72 mo | 5.1 y | 37.2 mo |
| Time period | 1997-2006 | 2001-2007 | 1998-2009 | 1996-2007 |
| Purine analog refractory disease, % | 87 | 47 | 55 | 83 |
| Cytogenetics | n = 7 (del17p), n = 7 (del11q), n = 9 (complex karyotype) | 18% del17p, 36% del11q | 17% del17p, 8% del11q | Not reported |
| Disease status SCT | 55% refractory disease | 21% refractory disease | 43% SD/PD | 17% refractory disease |
| Bulky disease SCT | 24% | Not reported | 21% | Not reported |
| Conditioning regimen | 2-Gy TBI ± fludarabine (URD) | Fludarabine + cyclophosphamide ± ATG (URD) | Fludarabine + busulphan | Fludarabine + cyclophosphamide+ rituximab |
| Donor status | 37% URD | 45% URD | 63% URD | Not reported |
| Relapse rate | 38% (5 y) | 46% (6 y) | 40% (5 y) | 39% (3 y) |
| PFS | 39% (5 y) | 38% (6-y EFS) | 43% (5 y) | 36% (5 y) |
| OS | 50% (5 y) | 58% (6 y) | 63% (5 y) | 51% (5 y) |
| Chronic extensive GVHD | 49% sib donor, 53% URD | 53% (35/66) | 65% (limited + extensive) at 2 y | 56% (5 y) |
| NRM | 23% (5 y) | 23% (6 y) | 16% (5 y) | 17.4% (1 y) |
| Reported use of MRD monitoring/DLI | No | Yes | No | Yes |
| Impact of pre-SCT cytogenetics on SCT outcomes | No impact | No impact | No impact | Not assessed |
| Prognostic factors that influenced outcome | Model to predict 3-y inferior OS: LN size ≥5 cm, HCT CI score ≥1 | Model to predict inferior EFS, OS, NRM: refractory disease at SCT, use of alemtuzumab prior to SCT | Model to predict inferior PFS: disease status at SCT, LDH, comorbidity, ALC | Model to predict inferior OS: hypogammaglobulinemia, CD4 <100/mm3 |
| . | Sorror et al* . | Dreger et al† . | Brown et al‡ . | Khouri et al§ . |
|---|---|---|---|---|
| No. of patients | 82 (n = 64 with 5-y follow-up) | 90 | 76 | 86 |
| Median follow-up | 5 y | 72 mo | 5.1 y | 37.2 mo |
| Time period | 1997-2006 | 2001-2007 | 1998-2009 | 1996-2007 |
| Purine analog refractory disease, % | 87 | 47 | 55 | 83 |
| Cytogenetics | n = 7 (del17p), n = 7 (del11q), n = 9 (complex karyotype) | 18% del17p, 36% del11q | 17% del17p, 8% del11q | Not reported |
| Disease status SCT | 55% refractory disease | 21% refractory disease | 43% SD/PD | 17% refractory disease |
| Bulky disease SCT | 24% | Not reported | 21% | Not reported |
| Conditioning regimen | 2-Gy TBI ± fludarabine (URD) | Fludarabine + cyclophosphamide ± ATG (URD) | Fludarabine + busulphan | Fludarabine + cyclophosphamide+ rituximab |
| Donor status | 37% URD | 45% URD | 63% URD | Not reported |
| Relapse rate | 38% (5 y) | 46% (6 y) | 40% (5 y) | 39% (3 y) |
| PFS | 39% (5 y) | 38% (6-y EFS) | 43% (5 y) | 36% (5 y) |
| OS | 50% (5 y) | 58% (6 y) | 63% (5 y) | 51% (5 y) |
| Chronic extensive GVHD | 49% sib donor, 53% URD | 53% (35/66) | 65% (limited + extensive) at 2 y | 56% (5 y) |
| NRM | 23% (5 y) | 23% (6 y) | 16% (5 y) | 17.4% (1 y) |
| Reported use of MRD monitoring/DLI | No | Yes | No | Yes |
| Impact of pre-SCT cytogenetics on SCT outcomes | No impact | No impact | No impact | Not assessed |
| Prognostic factors that influenced outcome | Model to predict 3-y inferior OS: LN size ≥5 cm, HCT CI score ≥1 | Model to predict inferior EFS, OS, NRM: refractory disease at SCT, use of alemtuzumab prior to SCT | Model to predict inferior PFS: disease status at SCT, LDH, comorbidity, ALC | Model to predict inferior OS: hypogammaglobulinemia, CD4 <100/mm3 |
ALC, absolute lymphocyte count; ATG, anti-thymocyte globulin; CLL, chronic lymphocytic leukemia; DLI, donor lymphocyte infusion; EFS, event-free survival; GVHD, graft-versus-host disease; HCT CI, hematopoietic cell transplant comorbidity index; LDH, lactate dehydrogenase; LN, lymph node; MRD, minimal residual disease; NRM, nonrelapse mortality; OS, overall survival; PD, progressive disease; PFS, progression-free survival; RIC, reduced-intensity conditioning; SCT, stem cell transplantation; SD, stable disease; TBI, total body irradiation; URD, unrelated donor.
Please see Sorror et al.35
Please see Dreger et al.36,50
Please see Brown et al.47
Please see Khouri et al.52