Originally published as JCO Early Release 10.1200/JCO.2008.16.2982 on August 18 2008

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Allogeneic Hematopoietic Stem-Cell Transplantation for Chronic Lymphocytic Leukemia With 17p Deletion: A Retrospective European Group for Blood and Marrow Transplantation Analysis

Johannes Schetelig, Anja van Biezen, Ronald Brand, Dolores Caballero, Rodrigo Martino, Maija Itala, José A. García-Marco, Liisa Volin, Norbert Schmitz, Rainer Schwerdtfeger, Arnold Ganser, Francesco Onida, Brigitte Mohr, Stephan Stilgenbauer, Martin Bornhäuser, Theo de Witte, Peter Dreger

From the University Hospital Carl Gustav Carus, Medizinische Klinik und Poliklinik I, Dresden; Department of Haematology and Stem Cell Transplantation, Asklepios Klinik St Georg, Hamburg; Deutsche Klinik für Diagnostik, Knochenmarktransplantation, Wiesbaden; Hannover Medical University, Department of Haematology/Oncology, Hannover; University Hospital, Medizinische Klinik und Poliklinik III, Ulm; University Hospital Heidelberg, Medizinische Klinik V, Heidelberg, Germany; Hospital Clínico, Servicio de Hematología, Salamanca; Hospital Santa Creu i Sant Pau, Clinical Haematology Division, Universitat Autonoma de Barcelona, Barcelona; Hospital Universitario Puerta de Hierro, Servicio de Hematologia, Madrid, Spain; Turku University, Central Hospital, Bone Marrow Transplantation Unit, Turku; Helsinki University Central Hospital, Helsinki, Finland; Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Ospedale Maggiore Policlinico Mangiagalli e Regina Elena and University of Milan, Milano, Italy; Chronic Leukemia Working Party, Department of Medical Statistics and Bioinformatics, Leiden University Medical Center, Leiden; and Department of Hematology, Radboud University–Nijmegen Medical Centre, Nijmegen, the Netherlands

Corresponding author: Johannes Schetelig, MD, Medizinische KIinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus, Fetscherstr. 74, 01307 Dresden, Germany; e-mail: johannes.schetelig{at}uniklinikum-dresden.de

Purpose Patients with chronic lymphocytic leukemia (CLL) and 17p deletion (17p–) have a poor prognosis. Although allogeneic hematopoietic stem-cell transplantation (HCT) has the potential to cure patients with advanced CLL, it is not known whether this holds true for patients with 17p–CLL.

Patients and Methods Baseline data from patients, for whom information on the presence of 17p–CLL was available, were downloaded from the European Group for Blood and Marrow Transplantation database. Additional information on the course of CLL and follow-up was collected with a questionnaire.

Results A total of 44 patients with 17p–CLL received allogeneic HCT between March 1995 and July 2006 from a matched sibling (n = 24) or an alternative donor (n = 20). 17p–CLL had been diagnosed by fluorescent in situ hybridization in 82% of patients and by conventional banding in 18% of patients. The median age was 54 years. Before HCT, a median of three lines of chemotherapy had been administered. At HCT, 53% of patients were in remission. Reduced-intensity conditioning was applied in 89% of patients. Acute, grade 2 to 4 graft-versus-host disease (GVHD) occurred in 43% of patients, and extensive chronic GVHD occurred in 53% of patients. At last follow-up, 19 patients were alive, with a median observation time of 39 months (range, 18 to 101 months). Three-year overall survival and progression-free survival rates were 44% and 37%, respectively. The cumulative incidence of progressive disease at 4 years was 34%. No late relapse occurred in nine patients with a follow-up longer than 4 years.

Conclusion Allogeneic HCT has the potential to induce long-term disease-free survival in patients with 17p–CLL.

published online ahead of print at www.jco.org on August 18, 2008.

Supported in part by the German José Carrerras Leukämiestiftung (R 03/01).

Presented at the 49th Annual Meeting of the American Society of Hematology, December 8-11, 2007, Atlanta, GA.

Authors’ disclosures of potential conflicts of interest and author contributions are found at the end of this article.

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