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Chronic Lymphocytic Leukemia and Normal B-cells

Reduced-intensity conditioning lowers treatment-related mortality of allogeneic stem cell transplantation for chronic lymphocytic leukemia: a population-matched analysis

Leukemia volume 19, pages 1029–1033 (2005)Cite this article

Abstract

To elucidate whether reduced-intensity conditioning (RIC) decreases treatment-related mortality (TRM) after allogeneic stem cell transplantation (allo-SCT) for chronic lymphocytic leukemia (CLL), we retrospectively compared 73 RIC cases from a recent EBMT survey with 82 patients from the EBMT database who had undergone standard myeloablative conditioning (MC) for CLL during the same time period. The two populations were matched by adjusting the primary risk factor, the conditioning regimen, in a series of Cox models for age, sex, donor type, remission status at transplant and analyzed for its effect on TRM, relapse incidence, event-free (EFS) and overall survival (OS). After adjustment, a significant reduction of TRM became evident for the RIC population (hazard ratio (HR) 0.4 (95% confidence interval 0.18–0.9); P=0.03). On the other hand, RIC was associated with an increased relapse incidence (HR 2.65 (0.98–7.12); P=0.054). There was no significant difference between RIC and MC in terms of EFS (HR 0.69 (0.38–1.25); P=0.22) and OS (HR 0.65 (0.33–1.28); P=0.21). We conclude that RIC appears to favorably influence TRM after allo-SCT for CLL. This observation, as well as possible detrimental effects of RIC on relapse risk, should be confirmed by prospective studies.

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Authors and Affiliations

  1. Department of Hematology, Allgemeines Krankenhaus St Georg, Hamburg, Germany

    P Dreger

  2. Department of Medicine V, University of Heidelberg, Germany

    P Dreger

  3. Department of Medical Statistics, University Medical Centre, Leiden, The Netherlands

    R Brand & A van Biezen

  4. Department of Haematology, Heartlands Hospital, Birmingham, UK

    D Milligan

  5. Bone Marrow Transplantation Unit, Istituto Nazionale dei Tumori, University of Milano, Italy

    P Corradini

  6. Department of Haematology and Oncology, University of Freiburg, Germany

    J Finke

  7. BMT Center, Ospedale Maggiore, Milano, Italy

    G Lambertenghi Deliliers

  8. Servicio de Hematologica Clinica, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain

    R Martino

  9. Haematology Department, Nottingham City Hospital, Nottingham, UK

    N Russell

  10. Unite de Greffe de Cellules Souches Hématopoïétiques, Hôpital Edouard Herriot, Lyon, France

    M Michallet

  11. Department of Hematology and Medical Oncology, University of Leipzig, Germany

    D Niederwieser

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  1. P Dreger
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  2. R Brand
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  4. P Corradini
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  5. J Finke
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  6. G Lambertenghi Deliliers
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  7. R Martino
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  8. N Russell
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  9. A van Biezen
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  11. D Niederwieser
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on behalf of the Chronic Leukemia Working Party of the EBMT

Corresponding author

Correspondence to P Dreger.

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Appendix A

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Dreger, P., Brand, R., Milligan, D. et al. Reduced-intensity conditioning lowers treatment-related mortality of allogeneic stem cell transplantation for chronic lymphocytic leukemia: a population-matched analysis. Leukemia 19, 1029–1033 (2005). https://doi.org/10.1038/sj.leu.2403745

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