Hematopoietic cell transplantation after nonmyeloablative conditioning for advanced chronic lymphocytic leukemia

Mohamed L. Sorror, Michael B. Maris, Brenda M. Sandmaier, Barry E. Storer, Monic J. Stuart, Ute Hegenbart, Edward Agura, Thomas R. Chauncey, Jose Leis, Michael Pulsipher, Peter McSweeney, Jerald P. Radich, Christopher Bredeson, Benedetto Bruno, Amelia Langston, Michael R. Loken, Haifa Al-Ali, Karl G. Blume, Rainer Storb, David G. Maloney

Research output: Contribution to journalArticlepeer-review

194 Scopus citations


Purpose: Patients with chemotherapy-refractory chronic lymphocytic leukemia (CLL) have a short life expectancy. The aim of this study was to analyze the outcome of patients with advanced CLL when treated with nonmyeloablative conditioning and hematopoietic cell transplantation (HCT). Patients and Methods: Sixty-four patients diagnosed with advanced CLL were treated with nonmyeloablative conditioning (2 Gy total-body irradiation with [n = 53] or without [n = 11] fludarabine) and HCT from related (n = 44) or unrelated (n = 20) donors. An adapted form of the Charlson comorbidity index was used to assess pretransplantation comorbidities. Results: Sixty-one of 64 patients had sustained engraftment, whereas three patients rejected their grafts. The incidences of grades 2, 3, and 4 acute and chronic graft-versus-host disease were 39%, 14%, 2%, and 50%, respectively. Three patients who underwent transplantation in complete remission (CR) remained in CR. The overall response rate among 61 patients with measurable disease was 67% (50% CR), whereas 5% had stable disease. All patients with morphologic CR who were tested by polymerase chain reaction (n = 11) achieved negative molecular results, and one of these patients subsequently experienced disease relapse. The 2-year incidence of relapse/progression was 26%, whereas the 2-year relapse and nonrelapse mortalities were 18% and 22%, respectively. Two-year rates of overall and disease-free survivals were 60% and 52%, respectively. Unrelated HCT resulted in higher CR and lower relapse rates than related HCT, suggesting more effective graft-versus-leukemia activity. Conclusion: CLL is susceptible to graft-versus-leukemia effects, and allogeneic HCT after nonmyeloablative conditioning might prolong median survival for patients with advanced CLL.

Original languageEnglish (US)
Pages (from-to)3819-3829
Number of pages11
JournalJournal of Clinical Oncology
Issue number16
StatePublished - 2005

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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