Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Allografting

Allogeneic related donor hematopoietic stem cell transplantation for treatment of chronic lymphocytic leukemia

Bone Marrow Transplantation volume 29, pages 817–823 (2002)Cite this article

Abstract

Between 1980 and 1999, 25 patients with chronic lymphocytic leukemia (CLL) received related donor hematopoietic stem cell transplants. Median patient age was 46.6 years. Preparative regimens included busulfan (BU) plus cyclophosphamide (CY), CY plus TBI, and etoposide, CY plus TBI. Twenty-one donors were HLA-identical siblings, one was a DR mismatched sibling, and three were identical twins. Bone marrow was the source of hematopoietic stem cells in 22 cases and G-CSF stimulated peripheral blood in three cases. Most patients received methotrexate and cyclosporine for GVHD prophylaxis. Fourteen patients developed grades 2–4 acute GVHD and 10 developed clinical extensive chronic GVHD. Late clearance of CLL cells was associated with the development of chronic GVHD in one patient. Two patients had recurrent CLL. Nonrelapse mortality at day 100 was 57% for the seven patients conditioned with BU/CY and 17% for the 18 patients conditioned with TBI-containing regimens. Actuarial survival at 5 years for the 25 patients is 32%. All patients who received BU/CY died within 3 years of transplant. For the 14 patients transplanted since 1992 and who received TBI, actuarial 5-year survival is 56%. The maximum response of CLL to hematopoietic cell transplantation may be delayed, but long-term disease-free survival can be achieved.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3

Similar content being viewed by others

References

  1. Rai KR, Peterson BL, Appelbaum FR et al. Fludarabine compared with chlorambucil as primary therapy for chronic lymphocytic leukemia New Engl J Med 2000 343: 1750 1757

    Article  CAS  PubMed  Google Scholar 

  2. Osterborg A, Dyer MJ, Bunjes D et al. Phase II multicenter study of human CD52 antibody in previously treated chronic lymphocytic leukemia. European Study Group of CAMPATH-1H Treatment in Chronic Lymphocytic Leukemia J Clin Oncol 1997 15: 1567 1574

    Article  CAS  PubMed  Google Scholar 

  3. Byrd JC, Murphy T, Howard RS et al. Rituximab using a thrice weekly dosing schedule in B-cell chronic lymphocytic leukemia and small lymphocytic lymphoma demonstrates clinical activity and acceptable toxicity J Clin Oncol 2001 19: 2153 2164

    Article  CAS  PubMed  Google Scholar 

  4. O'Brien SM, Kantarjian H, Thomas DA et al. Rituximab dose-escalation trial in chronic lymphocytic leukemia J Clin Oncol 2001 19: 2165 2170

    Article  CAS  PubMed  Google Scholar 

  5. Rai KR . A critical analysis of staging in CLL In Chronic Lymphocytic Leukemia: Recent Progress and Future Direction Alan R Liss: New York 1987 pp 253 264

    Google Scholar 

  6. Bensinger WI, Weaver CH, Appelbaum FR et al. Transplantation of allogeneic peripheral blood stem cells mobilized by recombinant human granulocyte colony-stimulating factor Blood 1995 85: 1655 1658

    CAS  PubMed  Google Scholar 

  7. Storb R, Deeg HJ, Farewell V et al. Marrow transplantation for severe aplastic anemia: Methotrexate alone compared with a combination of methotrexate and cyclosporine for prevention of acute graft-versus-host disease Blood 1986 68: 119 125

    CAS  PubMed  Google Scholar 

  8. Cheson BD, Bennett JM, Rai KR et al. Guidelines for clinical protocols for chronic lymphocytic leukemia: recommendations of the National Cancer Institute-sponsored Working Group Am J Hematol 1988 29: 152 163

    Article  CAS  PubMed  Google Scholar 

  9. Smith AG, Martin PJ . Analysis of amplified variable number tandem repeat loci for evaluation of engraftment after hematopoietic stem cell transplantation Rev Immunogenet 1999 1: 255 264

    CAS  PubMed  Google Scholar 

  10. Damle RN, Wasil T, Fais F et al. Ig V gene mutation status and CD38 expression as novel prognostic indicators in chronic lymphocytic leukemia Blood 1999 94: 1840 1847

    CAS  PubMed  Google Scholar 

  11. Hamblin TJ, Davis Z, Gardiner A et al. Unmutated Ig VH genes are associated with a more aggressive form of chronic lymphocytic leukemia Blood 1999 94: 1848 1854

    CAS  PubMed  Google Scholar 

  12. Glucksberg H, Storb R, Fefer A et al. Clinical manifestations of graft-versus-host disease in human recipients of marrow from HLA-matched sibling donors Transplantation 1974 18: 295 304

    Article  CAS  PubMed  Google Scholar 

  13. Sullivan KM, Agura E, Anasetti C et al. Chronic graft-versus-host disease and other late complications of bone marrow transplantation Semin Hematol 1991 28: 250 259

    CAS  PubMed  Google Scholar 

  14. Furlong T, Leisenring W, Storb R et al. Psoralen and ultraviolet A irradiation (PUVA) as therapy for steroid-resistant cutaneous acute graft-versus-host disease Biol Blood Marrow Transplant 2002 (in press)

  15. Kapoor N, Pelligrini AE, Copelan EA et al. Psoralen plus ultraviolet A (PUVA) in the treatment of chronic graft versus host disease: preliminary experience in standard treatment resistant patients Semin Hematol 1992 29: 108 112

    CAS  PubMed  Google Scholar 

  16. Marr KA, Seidel K, Slavin M et al. Prolonged fluconazole prophylaxis is associated with persistent protection against candidiasis-related death in allogeneic marrow transplant recipients: long-term follow-up of a randomized, placebo-controlled trial Blood 2000 96: 2055 2061

    CAS  PubMed  Google Scholar 

  17. Boeckh M, Gooley TA, Myerson D et al. Cytomegalovirus pp65 antigenemia-guided early treatment with ganciclovir versus ganciclovir at engraftment after allogeneic marrow transplantation: a randomized double-blind study Blood 1996 88: 4063 4071

    CAS  PubMed  Google Scholar 

  18. Kaplan EL, Meier P . Nonparametric estimation from incomplete observations J Am Stat Assoc 1958 53: 457 481

    Article  Google Scholar 

  19. Bensinger WI, Buckner CD, Clift RA et al. Phase I study of busulfan and cyclophosphamide in preparation for allogeneic marrow transplant for patients with multiple myeloma J Clin Oncol 1992 10: 1492 1497

    Article  CAS  PubMed  Google Scholar 

  20. Slattery JT, Sanders JE, Buckner CD et al. Graft-rejection and toxicity following bone marrow transplantation in relation to busulfan pharmacokinetics Bone Marrow Transplant 1995 16: 31 42

    CAS  PubMed  Google Scholar 

  21. Bensinger WI, Martin PJ, Storer B et al. Transplantation of bone marrow as compared with peripheral-blood cells from HLA-identical relatives in patients with hematologic cancers New Engl J Med 2001 344: 175 181

    Article  CAS  PubMed  Google Scholar 

  22. Rondon G, Giralt S, Huh Y et al. Graft-versus-leukemia effect after allogeneic bone marrow transplantation for chronic lymphocytic leukemia Bone Marrow Transplant 1996 18: 669 672

    CAS  PubMed  Google Scholar 

  23. Mehta J, Powles R, Singhal S et al. Clinical and hematologic response of chronic lymphocytic and prolymphocytic leukemia persisting after allogeneic bone marrow transplantation with the onset of acute graft-versus-host disease: possible role of graft-versus-leukemia Bone Marrow Transplant 1996 17: 371 375

    CAS  PubMed  Google Scholar 

  24. deMagalhaes-Silverman M, Donnenberg A, Hammert L et al. Induction of graft-versus-leukemia effect in a patient with chronic lymphocytic leukemia Bone Marrow Transplant 1997 20: 175 177

    Article  CAS  PubMed  Google Scholar 

  25. Pavletic ZS, Arrowsmith ER, Bierman PJ et al. Outcome of allogeneic stem cell transplantation for B cell chronic lymphocytic leukemia Bone Marrow Transplant 2000 25: 717 722

    Article  CAS  PubMed  Google Scholar 

  26. Khouri IF, Keating MJ, Vriesendorp HM et al. Autologous and allogeneic bone marrow transplantation for chronic lymphocytic leukemia: preliminary results J Clin Oncol 1994 12: 748 758

    Article  CAS  PubMed  Google Scholar 

  27. Rabinowe SN, Soiffer RJ, Gribben JG et al. Autologous and allogeneic bone marrow transplantation for poor prognosis patients with B-cell chronic lymphocytic leukemia Blood 1993 82: 1366 1376

    CAS  PubMed  Google Scholar 

  28. Michallet M, Archimbaud E, Bandini G et al. HLA-identical sibling bone marrow transplantation in younger patients with chronic lymphocytic leukemia. European Group for Blood and Marrow Transplantation and the International Bone Marrow Transplant Registry Ann Intern Med 1996 124: 311 315

    Article  CAS  PubMed  Google Scholar 

  29. Toze CL, Shepherd JD, Connors JM et al. Allogeneic bone marrow transplantation for low-grade lymphoma and chronic lymphocytic leukemia Bone Marrow Transplant 2000 25: 605 612

    Article  CAS  PubMed  Google Scholar 

  30. Horowitz MM, Montserrat E, Sobocinski K et al. Hematopoietic stem cell transplantation (SCT) for chronic lymphocytic leukemia (CLL) Blood 2000 96 (Part 1): 522a

    Google Scholar 

  31. Michallet M, Brand R, Dreger P et al. Allogeneic hematopoietic stem cell transplantation (HSCT) for chronic lymphocytic leukemia (CLL): results and prognostic factors for survival after transplantation. Analysis from EBMT registry Blood 2000 96 (Part 1): 205a

    Google Scholar 

  32. Dreger P, van Biezen A, Brand R et al. Prognostic factors for survival after autologous stem cell transplantation for chronic lymphocytic leukemia (CLL): the EBMT experience Blood 2000 96 (Part 1): 482a

    Google Scholar 

  33. Keating MJ, O'Brien S, Lerner S et al. Long-term follow-up of patients with chronic lymphocytic leukemia (CLL) receiving fludarabine regimens as initial therapy Blood 1998 92: 1165 1171

    CAS  PubMed  Google Scholar 

  34. McSweeney PA, Niederwieser D, Shizuru JA et al. Hematopoietic cell transplantation in older patients with hematologic malignancies: replacing high-dose cytotoxic therapy with graft-versus-tumor effects Blood 2001 97: 3390 3400

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    KC Doney, T Chauncey & FR Appelbaum

  2. Division of Oncology, University of Washington Medical Center, Seattle, WA, USA

    KC Doney, T Chauncey & FR Appelbaum

  3. VA Puget Sound Healthcare System, Seattle, WA, USA

    T Chauncey

Authors
  1. KC Doney
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. T Chauncey
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. FR Appelbaum
    View author publications

    You can also search for this author in PubMed Google Scholar

Consortia

for the Seattle Bone Marrow Transplant Team

Rights and permissions

Reprints and permissions

About this article

Cite this article

Doney, K., Chauncey, T., Appelbaum, F. et al. Allogeneic related donor hematopoietic stem cell transplantation for treatment of chronic lymphocytic leukemia. Bone Marrow Transplant 29, 817–823 (2002). https://doi.org/10.1038/sj.bmt.1703548

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.bmt.1703548

Keywords

This article is cited by

Search

Advanced search

Quick links