TY - JOUR
T1 - Long-term survival of patients with CLL after allogeneic transplantation
T2 - A report from the European Society for Blood and Marrow Transplantation
AU - Chronic Malignancy Working Party
AU - Van Gelder, M.
AU - De Wreede, L. C.
AU - Bornhäuser, M.
AU - Niederwieser, D.
AU - Karas, M.
AU - Anderson, N. S.
AU - Gramatzki, M.
AU - Dreger, P.
AU - Michallet, M.
AU - Petersen, E.
AU - Bunjes, D.
AU - Potter, M.
AU - Beelen, D.
AU - Cornelissen, J. J.
AU - Yakoub-Agha, I.
AU - Russell, N. H.
AU - Finke, J.
AU - Schoemans, H.
AU - Vitek, A.
AU - Urbano-Ispízua,
AU - Blaise, D.
AU - Volin, L.
AU - Chevallier, P.
AU - Caballero, D.
AU - Putter, H.
AU - Van Biezen, A.
AU - Henseler, A.
AU - Schönland, S.
AU - Kröger, N.
AU - Schetelig, J.
AU - Ehninger, Gerhard
AU - Jindra, Pavel
AU - Sengeloev, Henrik
AU - Potter, Michael
AU - Russell, Nigel
AU - Vitek, Antonin
AU - Ispizua, Alvaro Urbano
AU - Arnold, Renate
AU - Veelken, Joan Hendrik
AU - Mufti, Ghulam
AU - Milpied, Noel
AU - Benedetto, Bruno
AU - Schaap, Michel
AU - Leblond, Véronique
AU - Nikolousis, Manos
AU - Hallek, Michael
AU - Passweg, Jakob
AU - Ljungman, Per
AU - Masszi, Tamás
AU - Peschel, Christian
N1 - Publisher Copyright:
© 2017 Macmillan Publishers Limited, part of Springer Nature.
PY - 2017/3/1
Y1 - 2017/3/1
N2 - 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.
AB - 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.
UR - https://www.scopus.com/pages/publications/85014577257
U2 - 10.1038/bmt.2016.282
DO - 10.1038/bmt.2016.282
M3 - Article
C2 - 27941763
AN - SCOPUS:85014577257
SN - 0268-3369
VL - 52
SP - 372
EP - 380
JO - Bone Marrow Transplantation
JF - Bone Marrow Transplantation
IS - 3
ER -