Efficacy of cisplatin-based immunochemotherapy plus alloSCT in high-risk chronic lymphocytic leukemia: final results of a prospective multicenter phase 2 HOVON study.

Autor: van Gelder M; Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands., van Oers MH; Department of Hematology and Lymphoma and Myeloma Center, Academic Medical Center, Amsterdam, The Netherlands., Alemayehu WG; HOVON Data Center, Erasmus Medical Center, Rotterdam, The Netherlands., Abrahamse-Testroote MC; Department of Hematology, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands., Cornelissen JJ; Department of Hematology, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands., Chamuleau ME; Department of Hematology, Free University Medical Center, Amsterdam, The Netherlands., Zachée P; Department of Hematology, Ziekenhuis Netwerk Antwerpen Stuivenberg, Antwerpen, Belgium., Hoogendoorn M; Department of Internal Medicine, Medical Center Leeuwarden, Leeuwarden, The Netherlands., Nijland M; Department of Hematology, University Medical Center Groningen, Groningen, The Netherlands., Petersen EJ; Department of Hematology, University Medical Center Utrecht, Utrecht, The Netherlands., Beeker A; Department of Internal Medicine, Spaarne Ziekenhuis, Hoofddorp, The Netherlands., Timmers GJ; Department of Internal Medicine, Ziekenhuis Amstelland, Amstelveen, The Netherlands., Verdonck L; Department of Internal Medicine, Isala Klinieken, Zwolle, The Netherlands., Westerman M; Department of Internal Medicine, Medisch Centrum Alkmaar, Alkmaar, The Netherlands., de Weerdt O; Department of Internal Medicine, Antonius ziekenhuis Nieuwegein, Nieuwegein, The Netherlands., Kater AP; Department of Hematology and Lymphoma and Myeloma Center, Academic Medical Center, Amsterdam, The Netherlands.
Jazyk: angličtina
Zdroj: Bone marrow transplantation [Bone Marrow Transplant] 2016 Jun; Vol. 51 (6), pp. 799-806. Date of Electronic Publication: 2016 Feb 15.
DOI: 10.1038/bmt.2016.9
Abstrakt: Allogeneic stem cell transplantation (alloSCT) remains the only curative option for CLL patients. Whereas active disease at the time of alloSCT predicts poor outcome, no standard remission-induction regimen exists. We prospectively assessed outcome after cisplatin-containing immune-chemotherapy (R-DHAP) followed by alloSCT in 46 patients (median age 58 years) fulfilling modified European Society for Blood and Marrow Transplantation (EBMT) CLL Transplant Consensus criteria being refractory to or relapsed (R/R) <1 year after fludarabine or <2 years after fludarabine-based immunochemotherapy or R/R with del(17p). Twenty-nine patients received ⩾3 cycles of R-DHAP and sixteen <3 cycles (4 because of disease progression, 8 for toxicity and 4 toxic deaths). Overall rate of response to R-DHAP was 58%, 31 (67%) proceeded to alloSCT after conditioning with fludarabine and 2 Gy TBI. Twenty (65%) remained free from progression at 2 years after alloSCT, including 17 without minimal residual disease. Intention-to-treat 2-year PFS and overall survival of the 46 patients were 42 and 51% (35.5 months median follow-up); del(17p) or fludarabine refractoriness had no impact. R-DHAP followed by alloSCT is a reasonable treatment to be considered for high-risk CLL patients without access or resistance to targeted therapies.
Databáze: MEDLINE
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