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Chronic Lymphocytic Leukemia

The impact of HLA matching on long-term transplant outcome after allogeneic hematopoietic stem cell transplantation for CLL: a retrospective study from the EBMT registry

Leukemia volume 24, pages 1725–1731 (2010)Cite this article

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Abstract

We analyzed 368 chronic lymphocytic leukemia patients who underwent allogeneic hematopoietic stem cell transplantation reported to the EBMT registry between 1995 and 2007. There were 198 human leukocyte antigen (HLA)-identical siblings; among unrelated transplants, 31 were well matched in high resolution (‘well matched’ unrelated donor, WMUD), and 139 were mismatched (MM), including 30 matched in low resolution; 266 patients (72%) received reduced-intensity conditioning and 102 (28%) received standard. According to the EBMT risk score, 11% were in scores 1–3, 23% in score 4, 40% in score 5, 22% in score 6 and 4% in score 7. There was no difference in overall survival (OS) at 5 years between HLA-identical siblings (55% (48–64)) and WMUD (59% (41–84)), P=0.82. In contrast, OS was significantly worse for MM (37% (29–48) P=0.005) due to a significant excess of transplant-related mortality. Also OS worsened significantly when EBMT risk score increased. HLA matching had no significant impact on relapse (siblings: 24% (21–27); WMUD: 35% (26–44), P=0.11 and MM: 21% (18–24), P=0.81); alemtuzumab T-cell depletion and stem cell source (peripheral blood) were associated with an increased risk. Our findings support the use of WMUD as equivalent alternative to HLA-matched sibling donors for allogeneic HSCT in CLL, and justify the application of EBMT risk score in this disease.

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Acknowledgements

We are thankful to all the following investigators from EBMT centers who participated in this study: R Willemze, Leiden University Hospital, Leiden, The Netherlands; A Nagler, Tel-Hashomer, Tel Aviv, Israel; P Ljungman, Huddinge University Hospital, Huddinge, Sweden; K Remes, Turku University Central Hospital, Turku, Finland; H Greinix, AKH Vienna, Vienna, Austria; A Ganser, Hannover Medical University, Hannover, Germany; Y Beguin, University of Liege, Liege, Belgium; N Kröger, University Hospital Eppendorf, Hamburg, Germany; A Buzyn, Hôpital Necker, Paris, France; S Lenhoff, University Hospital, Lund, Sweden; R Schwerdtfeger, Deutsche Klinik für Diagnostik, Wiesbaden, Germany; AE Hunter, Leicester Royal Infirmary NHS Trust, Leicester, United Kingdom; P Dreger, University of Heidelberg, Heidelberg, Germany; M Sanz, Hospital Universitario La Fe,Valencia, Spain; I Franklin, Glasgow Royal Infirmary, Glascow, Scotland, United Kingdom; S Robinson, Bristol Oncology Centre, Bristol, United Kingdom; HG Sayer, Friedrich-Schiller University, Jena, Germany; M Hallek, University of Cologne, Cologne, Germany; Liu Yin J, Manchester Royal Infirmary., Manchester, United Kingdom; T Littlewood, The Oxford Radcliffe Hospital, Oxford, United Kingdom; G Cook, St James' University Hospital, Leeds, United Kingdom; H Malek, Centre Hospitalier, Meaux, France; T Nousiainen, Kuopio University Hospital, Kuopio, Finland; L Uharek, Klin. Benjamin Franklin, FU Berlin, Berlin, Germany; and K Theunissen, Virga Jesse Hospital, Hasselt, Belgium.

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Authors and Affiliations

  1. Department of Hematology, Edouard Herriot Hospital, Lyon, France

    M Michallet, M Sobh, S Morisset & V Dubois

  2. Department of Hematology, Birmingham Heartlands Hospital, Birmingham, UK

    D Milligan

  3. Department of Hematology, University of Leipzig, Leipzig, Germany

    D Niederwieser

  4. Department of Hematology and Oncology, University Hospital Pilsen, Pilsen, Czech Republic

    V Koza

  5. Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland

    T Ruutu

  6. Centre for Clinical Haematology, Nottingham University Hospital, Nottingham, UK

    N H Russell

  7. Department of Hematology, University Medical Centre, Utrecht, The Netherlands,

    L Verdonck

  8. Service d'Hématologie Clinique, Hôpital Pitié-Salpêtrière, Paris, France

    N Dhedin

  9. Institute of Hematology and Blood Transfusion, Prague, Czech Republic

    A Vitek

  10. Department of Hematology, University Hospital of Leuven, Leuven, Belgium

    M Boogaerts

  11. Department of Hematology, Rigshospitalet, Copenhagen, Denmark

    L Vindelov

  12. Department of Hematology/Oncology, University Medical Center Freiburg, Freiburg, Germany

    J Finke

  13. Department of Medical Statistics and Bioinformatics, Leiden University Medical Centre, Leiden, The Netherlands

    A van Biezen & R Brand

  14. Central Hematology Laboratory, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands

    T de Witte

  15. Department of Internal Medicine, University Hospital Heidelberg, Heidelberg, Germany

    P Dreger

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Correspondence to M Michallet.

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Michallet, M., Sobh, M., Milligan, D. et al. The impact of HLA matching on long-term transplant outcome after allogeneic hematopoietic stem cell transplantation for CLL: a retrospective study from the EBMT registry. Leukemia 24, 1725–1731 (2010). https://doi.org/10.1038/leu.2010.165

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