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Chronic Lymphocytic Leukemia

Genetically identical twin transplantation for chronic lymphocytic leukemia

Leukemia volume 21, pages 2452–2455 (2007)Cite this article

Abstract

We identified 19 persons with B-cell chronic lymphocytic leukemia (CLL) who received genetically identical twin blood cell or bone marrow transplants after high-dose conditioning. Ten are alive (eight disease-free) with a median follow-up of 89 months (range, 31–171 months); 5-year relapse rate was 50% (95% confidence interval (CI), 26–73%). Estimated 5-year survival and disease-free survival were 61% (95% CI, 37–82%) and 45% (95% CI, 23–68%). In two of four patients tested at 12 and 21 months by polymerase chain reaction no evidence of residual CLL was detected post-transplant. In one recipient who relapsed at 6 years, molecular studies showed a different CLL clone from that detected pretransplant. This clone was subsequently identified in the donor suggesting transfer of occult leukemia at the time of transplant. Genetically identical twin transplants can result in long-term disease-free survival and molecular remissions, these data suggest the potential for CLL control in the absence of allogeneic graft-versus-leukemia effect. The case of leukemia transfer indicates the need for careful evaluation of donors prior to graft collection.

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Acknowledgements

We want to specifically acknowledge European Group for Blood and Marrow Transplantation (EBMT) for the enthusiastic commitment and contributions to this study. We thank Dr Mark DeWolfe of Kansas City, Missouri for his assistance in providing the supplemental clinical information. We also thank the hospital and research staff in participating centers for their dedication in working on this study. The opinions expressed in this article are those of the authors and do not represent the official position of the National Institutes of Health the Food and Drug Administration or the US Government. This work is supported in part by the intramural programs of the National Cancer Institute, Center for Cancer Research.

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Authors and Affiliations

  1. National Cancer Institute, Center for Cancer Research, National Institutes of Health, Bethesda, MD, USA

    S Z Pavletic

  2. Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, USA

    G Zhou & W C Chan

  3. Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI, USA

    K Sobocinski & R P Gale

  4. Division of Cell and Gene Therapies, United States Food and Drug Administration, CBER, Bethesda, MD, USA

    G Marti

  5. Department of Medicine, University of Washington, Seattle, WA, USA

    K Doney

  6. Division of Oncology, Department of Medicine, Washington University School of Medicine, St Louis, MO, USA

    J DiPersio

  7. Clinic of Hematology, Erasme University Hospital (ULB), Brussels, Belgium

    W Feremans

  8. Department of Haematology, Royal Free Hospital and School of Medicine, University College, London, UK

    L Foroni & G Prentice

  9. Division of Hematology and Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA

    S Goodman

  10. Division of Adult Stem Cell Transplantation, Texas Transplant Institute, San Antonio, TX, USA

    C LeMaistre

  11. Department of Hematology-Oncology, Institute of Hematology, Sant’ Orsola University Hospital, Bologna, Italy

    G Bandini

  12. Department of Hematology, Cliniques Universitaires Saint-Luc, Universite catholique de Louvain, Brussels, Belgium

    A Ferrant

  13. Department of Hematology, Rigshospitalet University Hospital, Copenhagen, Denmark

    N Jacobsen

  14. Department of Stem Cell Transplantation, MD Anderson Cancer Center, University of Texas, Houston, TX, USA

    I Khouri & S Giralt

  15. National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA

    A Wiestner

  16. Department of Hematology, Institute of Hematology and Oncology, Hospital Clinic, IDIBAPS, University of Barcelona, Spain

    E Montserrat

  17. Division of Neoplastic Diseases, Medical College of Wisconsin, Milwaukee, WI, USA

    C Bredeson

Authors
  1. S Z Pavletic
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  2. G Zhou
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  3. K Sobocinski
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  4. G Marti
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  7. W Feremans
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  8. L Foroni
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  9. S Goodman
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  11. C LeMaistre
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  12. G Bandini
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  13. A Ferrant
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  14. N Jacobsen
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  15. I Khouri
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  16. R P Gale
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  17. A Wiestner
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  18. S Giralt
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  19. E Montserrat
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  20. W C Chan
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  21. C Bredeson
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for the Center for International Blood and Marrow Transplant Research (CIBMTR), Medical College of Wisconsin, Milwaukee, USA

Corresponding author

Correspondence to S Z Pavletic.

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Supplementary Information accompanies the paper on the Leukemia website (http://www.nature.com/leu)

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Pavletic, S., Zhou, G., Sobocinski, K. et al. Genetically identical twin transplantation for chronic lymphocytic leukemia. Leukemia 21, 2452–2455 (2007). https://doi.org/10.1038/sj.leu.2404928

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  • DOI: https://doi.org/10.1038/sj.leu.2404928

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