Risk factors for treatment failure after allogeneic transplantation of patients with CLL: a report from the European Society for Blood and Marrow Transplantation
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Risk factors for treatment failure after allogeneic transplantation of patients with CLL: a report from the European Society for Blood and Marrow Transplantation. / Schetelig, J; de Wreede, L C; van Gelder, M; Andersen, N S; Moreno, C; Vitek, A; Karas, M; Michallet, M; Machaczka, M; Gramatzki, M; Beelen, D; Finke, J; Delgado, J; Volin, L; Passweg, J; Dreger, P; Henseler, A; van Biezen, A; Bornhäuser, M; Schönland, S O; Kröger, N.
In: BONE MARROW TRANSPL, Vol. 52, No. 4, 04.2017, p. 552-560.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Risk factors for treatment failure after allogeneic transplantation of patients with CLL: a report from the European Society for Blood and Marrow Transplantation
AU - Schetelig, J
AU - de Wreede, L C
AU - van Gelder, M
AU - Andersen, N S
AU - Moreno, C
AU - Vitek, A
AU - Karas, M
AU - Michallet, M
AU - Machaczka, M
AU - Gramatzki, M
AU - Beelen, D
AU - Finke, J
AU - Delgado, J
AU - Volin, L
AU - Passweg, J
AU - Dreger, P
AU - Henseler, A
AU - van Biezen, A
AU - Bornhäuser, M
AU - Schönland, S O
AU - Kröger, N
PY - 2017/4
Y1 - 2017/4
N2 - For young patients with high-risk CLL, BTK-/PI3K-inhibitors or allogeneic stem cell transplantation (alloHCT) are considered. Patients with a low risk of non-relapse mortality (NRM) but a high risk of failure of targeted therapy may benefit most from alloHCT. We performed Cox regression analyses to identify risk factors for 2-year NRM and 5-year event-free survival (using EFS as a surrogate for long-term disease control) in a large, updated EBMT registry cohort (n= 694). For the whole cohort, 2-year NRM was 28% and 5-year EFS 37%. Higher age, lower performance status, unrelated donor type and unfavorable sex-mismatch had a significant adverse impact on 2-year NRM. Two-year NRM was calculated for good- and poor-risk reference patients. Predicted 2-year-NRM was 11 and 12% for male and female good-risk patients compared with 42 and 33% for male and female poor-risk patients. For 5-year EFS, age, performance status, prior autologous HCT, remission status and sex-mismatch had a significant impact, whereas del(17p) did not. The model-based prediction of 5-year EFS was 55% and 64%, respectively, for male and female good-risk patients. Good-risk transplant candidates with high-risk CLL and limited prognosis either on or after failure of targeted therapy should still be considered for alloHCT.
AB - For young patients with high-risk CLL, BTK-/PI3K-inhibitors or allogeneic stem cell transplantation (alloHCT) are considered. Patients with a low risk of non-relapse mortality (NRM) but a high risk of failure of targeted therapy may benefit most from alloHCT. We performed Cox regression analyses to identify risk factors for 2-year NRM and 5-year event-free survival (using EFS as a surrogate for long-term disease control) in a large, updated EBMT registry cohort (n= 694). For the whole cohort, 2-year NRM was 28% and 5-year EFS 37%. Higher age, lower performance status, unrelated donor type and unfavorable sex-mismatch had a significant adverse impact on 2-year NRM. Two-year NRM was calculated for good- and poor-risk reference patients. Predicted 2-year-NRM was 11 and 12% for male and female good-risk patients compared with 42 and 33% for male and female poor-risk patients. For 5-year EFS, age, performance status, prior autologous HCT, remission status and sex-mismatch had a significant impact, whereas del(17p) did not. The model-based prediction of 5-year EFS was 55% and 64%, respectively, for male and female good-risk patients. Good-risk transplant candidates with high-risk CLL and limited prognosis either on or after failure of targeted therapy should still be considered for alloHCT.
KW - Journal Article
U2 - 10.1038/bmt.2016.329
DO - 10.1038/bmt.2016.329
M3 - SCORING: Journal article
C2 - 28112746
VL - 52
SP - 552
EP - 560
JO - BONE MARROW TRANSPL
JF - BONE MARROW TRANSPL
SN - 0268-3369
IS - 4
ER -