Swe Mar Linn, Ram Vasudevan Nampoothiri, Carol Chen, Ivan Pasic, Zeyad Al-Shaibani, Wilson Lam, Arjun Datt Law, Fotios V Michelis, Dennis D H Kim, Armin Gerbitz, Jeffrey Lipton, Rajat Kumar, Jonas Mattsson, Auro Viswabandya
{"title":"异基因造血干细胞移植后诊断为慢性淋巴细胞白血病患者的预后:来自三级保健中心的结果。","authors":"Swe Mar Linn, Ram Vasudevan Nampoothiri, Carol Chen, Ivan Pasic, Zeyad Al-Shaibani, Wilson Lam, Arjun Datt Law, Fotios V Michelis, Dennis D H Kim, Armin Gerbitz, Jeffrey Lipton, Rajat Kumar, Jonas Mattsson, Auro Viswabandya","doi":"10.1016/j.hemonc.2021.09.008","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Allogeneic hematopoietic stem cell transplantation (allo-HCT) is currently the only curative treatment for patients with chronic lymphocytic leukemia (CLL).</p><p><strong>Methods: </strong>We analyzed the outcomes of 93 patients (median age: 52 years) who underwent allo-HCT at our center between 1989 and 2019.</p><p><strong>Results: </strong>After a median follow-up of 35 months, relapse was observed in 15.1% (n = 14) patients. The estimated 2-year non-relapse mortality, relapse-free survival, and overall survival (OS) were 38.1%, 54.2%, and 58.7%, respectively. The ECOG performance status ≥ 2 (hazard ratio [HR]: 4.1; p = .001) and use of total body irradiation (in a myeloablative conditioning regimen; HR: 2.64; p = .005) were predictive of poor OS after multivariable analysis. The occurrence of sinusoidal obstruction syndrome/veno-occlusive disease post-transplant was associated with poor survival (p = .001).</p><p><strong>Conclusion: </strong>Although the use of kinase and bcl2 inhibitors may result in a decrease in the number and need of transplants, allo-HCT remains a viable option in selected patients with high-risk CLL and good performance status.</p>","PeriodicalId":39226,"journal":{"name":"Hematology/ Oncology and Stem Cell Therapy","volume":"16 3","pages":"230-237"},"PeriodicalIF":0.0000,"publicationDate":"2023-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Outcomes of Patients Diagnosed With Chronic Lymphocytic Leukemia After Allogeneic Hematopoietic Stem Cell Transplantation: Results From a Tertiary Care Center.\",\"authors\":\"Swe Mar Linn, Ram Vasudevan Nampoothiri, Carol Chen, Ivan Pasic, Zeyad Al-Shaibani, Wilson Lam, Arjun Datt Law, Fotios V Michelis, Dennis D H Kim, Armin Gerbitz, Jeffrey Lipton, Rajat Kumar, Jonas Mattsson, Auro Viswabandya\",\"doi\":\"10.1016/j.hemonc.2021.09.008\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Allogeneic hematopoietic stem cell transplantation (allo-HCT) is currently the only curative treatment for patients with chronic lymphocytic leukemia (CLL).</p><p><strong>Methods: </strong>We analyzed the outcomes of 93 patients (median age: 52 years) who underwent allo-HCT at our center between 1989 and 2019.</p><p><strong>Results: </strong>After a median follow-up of 35 months, relapse was observed in 15.1% (n = 14) patients. The estimated 2-year non-relapse mortality, relapse-free survival, and overall survival (OS) were 38.1%, 54.2%, and 58.7%, respectively. The ECOG performance status ≥ 2 (hazard ratio [HR]: 4.1; p = .001) and use of total body irradiation (in a myeloablative conditioning regimen; HR: 2.64; p = .005) were predictive of poor OS after multivariable analysis. The occurrence of sinusoidal obstruction syndrome/veno-occlusive disease post-transplant was associated with poor survival (p = .001).</p><p><strong>Conclusion: </strong>Although the use of kinase and bcl2 inhibitors may result in a decrease in the number and need of transplants, allo-HCT remains a viable option in selected patients with high-risk CLL and good performance status.</p>\",\"PeriodicalId\":39226,\"journal\":{\"name\":\"Hematology/ Oncology and Stem Cell Therapy\",\"volume\":\"16 3\",\"pages\":\"230-237\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-04-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Hematology/ Oncology and Stem Cell Therapy\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1016/j.hemonc.2021.09.008\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Hematology/ Oncology and Stem Cell Therapy","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1016/j.hemonc.2021.09.008","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"Medicine","Score":null,"Total":0}
Outcomes of Patients Diagnosed With Chronic Lymphocytic Leukemia After Allogeneic Hematopoietic Stem Cell Transplantation: Results From a Tertiary Care Center.
Background: Allogeneic hematopoietic stem cell transplantation (allo-HCT) is currently the only curative treatment for patients with chronic lymphocytic leukemia (CLL).
Methods: We analyzed the outcomes of 93 patients (median age: 52 years) who underwent allo-HCT at our center between 1989 and 2019.
Results: After a median follow-up of 35 months, relapse was observed in 15.1% (n = 14) patients. The estimated 2-year non-relapse mortality, relapse-free survival, and overall survival (OS) were 38.1%, 54.2%, and 58.7%, respectively. The ECOG performance status ≥ 2 (hazard ratio [HR]: 4.1; p = .001) and use of total body irradiation (in a myeloablative conditioning regimen; HR: 2.64; p = .005) were predictive of poor OS after multivariable analysis. The occurrence of sinusoidal obstruction syndrome/veno-occlusive disease post-transplant was associated with poor survival (p = .001).
Conclusion: Although the use of kinase and bcl2 inhibitors may result in a decrease in the number and need of transplants, allo-HCT remains a viable option in selected patients with high-risk CLL and good performance status.
期刊介绍:
Hematology Oncology and Stem Cell Therapy is an international, peer-reviewed, open access journal that provides a vehicle for publications of high-quality clinical as well as basic science research reports in hematology and oncology. The contents of the journal also emphasize the growing importance of hematopoietic stem cell therapy for treatment of various benign and malignant hematologic disorders and certain solid tumors.The journal prioritizes publication of original research articles but also would give consideration for brief reports, review articles, special communications, and unique case reports. It also offers a special section for clinically relevant images that provide an important educational value.