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Indications for allogeneic stem cell transplantation in chronic lymphocytic leukemia: the EBMT transplant consensus

Leukemia volume 21, pages 12–17 (2007)Cite this article

Abstract

The aim of this project was to identify situations where allogeneic stem cell transplantation (allo-SCT) might be considered as a preferred treatment option for patients with B-cell chronic lymphocytic leukemia (CLL). Based on a MEDLINE search and additional sources, a consented proposal was drafted, refined and approved upon final discussion by an international expert panel. Key elements of the consensus are (1) allo-SCT is a procedure with evidence-based efficacy in poor-risk CLL; (2) although definition of ‘poor-risk CLL’ requires further investigation, allo-SCT is a reasonable treatment option for younger patients with (i) non-response or early relapse (within 12 months) after purine analogues, (ii) relapse within 24 months after having achieved a response with purine-analogue-based combination therapy or autologous transplantation, and (iii) patients with p53 abnormalities requiring treatment; and (3) optimum transplant strategies may vary according to distinct clinical situations and should be defined in prospective trials. This is the first attempt to define standard indications for allo-SCT in CLL. Nevertheless, whenever possible, allo-SCT should be performed within disease-specific prospective clinical protocols in order to continuously refine transplant indications according to new developments in risk assessment and treatment of CLL.

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Acknowledgements

This proposal has been adopted for the German CLL Study Group (GCLLSG; Chairman: Professor Dr M Hallek, Cologne) by the GCLLSG general assembly on November 4, 2005. PD, PC, EK, MM, DM, JS, WW, DN and EM participated in designing the project; all authors reviewed and interpreted available data; PD and EM wrote the paper; and all authors checked the final version of the manuscript. This work was presented in preliminary version in abstract form at the XI International Workshop on CLL, New York, September 2005.

Author information

Authors and Affiliations

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

    P Dreger

  2. Department of Hematology, Istituto Nazionale dei Tumori, University of Milano, Milano, Italy

    P Corradini

  3. Hematology Center, Karolinska University Hospital, Huddinge, Sweden

    E Kimby

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

    M Michallet

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

    D Milligan

  6. Department of Medicine I, University of Dresden, Dresden, Germany

    J Schetelig

  7. Department of Haematology, Oncology and Internal Medicine, Medical University of Warsaw, Warsaw, Poland

    W Wiktor-Jedrzejczak

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

    D Niederwieser

  9. Department of Medicine I, University of Cologne, Cologne, Germany

    M Hallek

  10. Hematology Department, Institute of Hematology and Oncology, IDIBAPS. Hospital Clínic, University of Barcelona, Barcelona, Spain

    E Montserrat

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on behalf of the Chronic Leukemia Working Party of the EBMT

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Correspondence to P Dreger.

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Dreger, P., Corradini, P., Kimby, E. et al. Indications for allogeneic stem cell transplantation in chronic lymphocytic leukemia: the EBMT transplant consensus. Leukemia 21, 12–17 (2007). https://doi.org/10.1038/sj.leu.2404441

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  • DOI: https://doi.org/10.1038/sj.leu.2404441

Keywords

  • CLL
  • salvage treatment
  • allogeneic stem cell transplantation
  • practice guidelines

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