Even with the availability of targeted drugs, allogeneic hematopoietic cell transplantation (allo-HCT) is the only therapy with curative potential for patients with CLL. Cure can be assessed by comparing long-term survival of patients to the matched general population. Using data from 2589 patients who received allo-HCT between 2000 and 2010, we used landmark analyses and methods from relative survival analysis to calculate excess mortality compared with an age-, sex- and calendar year-matched general population. Estimated event-free survival, overall survival and non-relapse mortality (NRM) 10 years after allo-HCT were 28% (95% confidence interval (CI), 25-31), 35% (95% CI, 32-38) and 40% (95% CI, 37-42), respectively. Patients who passed the 5-year landmark event-free survival (N=394) had a 79% probability (95% CI, 73-85) of surviving the subsequent 5 years without an event. Relapse and NRM contributed equally to treatment failure. Five-year mortality for 45- and 65-year-old reference patients who were event-free at the 5-year landmark was 8% and 47% compared with 3% and 14% in the matched general population, respectively. The prospect of long-term disease-free survival remains an argument to consider allo-HCT for young patients with high-risk CLL, and programs to understand and prevent late causes of failure for long-term survivors are warranted, especially for older patients.

Long-term survival of patients with CLL after allogeneic transplantation: A report from the European Society for Blood and Marrow Transplantation

Benedetto B.;Irrera G.;Corradini P.;Sica S.;Marotta G.;Hellmann A.;Spencer A.;Benedetti F.;Hahn;Martin H.;Fagioli F.;Specchia G.;
2017-01-01

Abstract

Even with the availability of targeted drugs, allogeneic hematopoietic cell transplantation (allo-HCT) is the only therapy with curative potential for patients with CLL. Cure can be assessed by comparing long-term survival of patients to the matched general population. Using data from 2589 patients who received allo-HCT between 2000 and 2010, we used landmark analyses and methods from relative survival analysis to calculate excess mortality compared with an age-, sex- and calendar year-matched general population. Estimated event-free survival, overall survival and non-relapse mortality (NRM) 10 years after allo-HCT were 28% (95% confidence interval (CI), 25-31), 35% (95% CI, 32-38) and 40% (95% CI, 37-42), respectively. Patients who passed the 5-year landmark event-free survival (N=394) had a 79% probability (95% CI, 73-85) of surviving the subsequent 5 years without an event. Relapse and NRM contributed equally to treatment failure. Five-year mortality for 45- and 65-year-old reference patients who were event-free at the 5-year landmark was 8% and 47% compared with 3% and 14% in the matched general population, respectively. The prospect of long-term disease-free survival remains an argument to consider allo-HCT for young patients with high-risk CLL, and programs to understand and prevent late causes of failure for long-term survivors are warranted, especially for older patients.
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Van Gelder M.; De Wreede L.C.; Bornhauser M.; Niederwieser D.; Karas M.; Anderson N.S.; Gramatzki M.; Dreger P.; Michallet M.; Petersen E.; Bunjes D.; Potter M.; Beelen D.; Cornelissen J.J.; Yakoub-Agha I.; Russell N.H.; Finke J.; Schoemans H.; Vitek A.; Urbano-Ispizua A.; Blaise D.; Volin L.; Chevallier P.; Caballero D.; Putter H.; Van Biezen A.; Henseler A.; Schonland S.; Kroger N.; Schetelig J.; Ehninger G.; Jindra P.; Sengeloev H.; Potter M.; Russell N.; Vitek A.; Ispizua A.U.; Arnold R.; Veelken J.H.; Mufti G.; Milpied N.; Benedetto B.; Schaap M.; Leblond V.; Nikolousis M.; Hallek M.; Passweg J.; Ljungman P.; Masszi T.; Stelljes M.; Browne P.; Glass B.; Espiga C.R.; Bourhis J.H.; Roussy G.; Gribben J.; Foa R.; Sierra J.; Mayer J.; Thomson K.; Meijer E.; Blau W.; Holler E.; Bacigalupo A.; Guilhot F.; Carlson K.; Zachee P.; Ifrah N.; Marin J.R.C.; Socie G.; McQuaker G.; Cortelezzi A.; Lenhoff S.; Tischer J.; Irrera G.; Fanin R.; Beguin Y.; Nagler A.; Mackinnon S.; Itala-Remes M.; Deconinck E.; Wulf G.; Corradini P.; Gilleece M.; Wing B.; Peniket A.; Ganser A.; Stuhler G.; Faber E.; Komarnicki M.; Kanz L.; Brune M.; Lamy T.; Sanz M.; Kyrcz-Krzemien S.; Orchard K.; Hunter A.; Sandstedt A.; Fegueux N.; Bandini G.; Robinson S.; Craddock C.; Crawley C.; Griskevicius L.; Bloor A.; Reman O.; Hilgendorf I.; Cannell P.; Ciceri F.; Kalhs P.; Sica S.; Greinix H.; Scime R.; Selleslag D.; Kruger W.; Huynh A.; Einsele H.; Bittenbring J.; Olivieri A.; Hermine O.; Gedde-Dahl T.; Zsiros J.; Guyotat D.; Cordonnier C.; Campos A.; Casini M.; Martinelli G.; Muller L.P.; Van Imhoff G.; Neubauer A.; Lioure B.; Hamladji R.-M.; Noens L.; Theobald M.; Salvi F.; Ram R.; Poire X.; Or R.; Chalandon Y.; Solano C.; Wilson K.; Santasusana J.M.R.; Karakasis D.; Schafer-Eckart K.; Wahlin A.; Mohty M.; Velardi A.; Bron D.; Alegre A.; Cairoli R.; Marotta G.; Lange A.; Narni F.; Fauser A.; Rambaldi A.; Guillerm G.; Heras I.; Snowden J.; Wiktor-Jedrzejczak W.; Schanz U.; Cahn J.Y.; Abecasis M.; Kobbe G.; Salim R.; Junghanss C.; Segel E.K.; Clement L.; Zak P.; Metzner B.; Espigado I.; Tilly H.; Schroyens W.; Favre C.; Russo D.; Gastl G.; Bay J.-O.; Alessandrino E.P.; Majolino I.; Bosi A.; Zuckerman T.; Aljurf M.; Thomson J.; Pioltelli P.; Anagnostopoulos A.; Schouten H.; Tholouli E.; Gurman G.; Vural F.; Zver S.; Muniz S.G.; Afanasyev B.; Pohlreich D.; Hellmann A.; Rosler W.; Martin S.; Apperley J.; Finnegan D.; Renaud M.; Nemet D.; Culligan D.; Castagna L.; Cascavilla N.; Koh M.; Chacon M.J.; Ozdogu H.; Spencer A.; Llamas C.V.; Grasso M.; Lopez S.G.; Benedetti F.; Deeren D.; De Revel T.; Musso M.; Halaburda K.; Sureda A.; Angelucci E.; Diez-Martin J.L.; Hunter H.; Koc Y.; Bordessoule D.; Fouillard L.; Di Bartolomeo P.; Mazza P.; Novitzky N.; Peschel C.; Lopez J.L.B.; Cascon M.J.P.; Romeril K.R.; Schots R.; Brussel H.; Koistinen P.; Arcese W.; Aktan M.; Rodeghiero F.; Butler A.; Pizzuti M.; Melpignano A.; Carella A.M.; Valcarcel D.; De Toledo Codina J.S.; Galieni P.; Bader P.; Hahn; Cavanna L.; Sucak G.; Broom A.J.M.; Garcia P.G.; Nicolas-Virelizier E.; Rizzoli V.; Witz F.; Potter M.; Collin M.; Ringhoffer M.; Kansu E.; Martin H.; Moraleda J.; Pranger D.; Greil R.; Bazarbachi A.; Ozturk M.; Fagioli F.; Jantunen E.; Yeshurun M.; Altuntas F.; Bassan R.; Rohrlich P.-S.; Jimenez S.; Glaisner S.; Vinante O.; Clausen J.; Lopez-Jimenez J.; Theunissen K.; Specchia G.; Pavone V.; Krauter J.; Edwards D.; Rifon J.; Everaus H.; Da Prada G.A.; Wattad M.; Milone G.; Walewski J.; Thieblemont C.; Nasa G.L.; Duchosal M.; Ferrara F.; Devidas A.; Delmer A.; Degos L.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2318/1844068
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