Original Article
Bone Marrow Transplantation (2006) 37, 1093–1098. doi:10.1038/sj.bmt.1705375; published online 8 May 2006
Autografting
Autologous stem cell transplantation in patients with chronic lymphocytic leukaemia: the Finnish experience
E Jantunen1, M Itälä2, T Siitonen3, E Juvonen4, E Koivunen5, P Koistinen3, L Volin4, K Remes2 and T Nousiainen1
- 1Department of Medicine, Kuopio University Hospital, Kuopio, Finland
- 2Department of Medicine, Turku University Central Hospital, Turku, Finland
- 3Department of Medicine, Oulu University Hospital, Oulu, Finland
- 4Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland
- 5Department of Medicine, Tampere University Hospital, Tampere, Finland
Correspondence: Dr E Jantunen, Department of Medicine, Kuopio University Hospital, PO Box 1777, 70211 Kuopio, Finland. E-mail: esa.jantunen@kuh.fi
Received 24 January 2006; Revised 23 March 2006; Accepted 25 March 2006; Published online 8 May 2006.
Abstract
Although autologous stem cell transplantation (ASCT) has gained some popularity as a treatment option in patients with chronic lymphocytic leukaemia (CLL), limited multicentre data are available on the feasibility and efficacy of this approach. Between January 1995 and June 2005, 72 patients with CLL received ASCT in five Finnish centres. There were 45 men and 27 women with a median age of 57 years (38–69). The median time from diagnosis to ASCT was 32 months (6–181) and the median number of prior regimens 1 (1–4). All patients received blood stem cell grafts and CD34+ selection had been performed in 44 patients (61%). The most common high-dose regimen was a total body irradiation plus cyclophosphamide (38 patients, 53%). No early treatment-related deaths were observed. With a median follow-up of 28 months from ASCT, a relapse or progression has been observed in 27 patients (37%). The projected progression-free survival is 48 months (confidence interval (CI) 30–66). The projected median overall survival is 95 months (CI 74–101) from ASCT and is not influenced by graft selection or conditioning regimen used. Autologous stem cell transplantation is a feasible treatment option for CLL. Randomized trials against alternative treatments are needed to assess the impact of ASCT on the clinical course of CLL.
Keywords:
autologous stem cell transplantation, chronic lymphocytic leukaemia, feasibility, outcome
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