Risk factors for treatment failure after allogeneic transplantation of patients with CLL : A report from the European Society for Blood and Marrow Transplantation
Autor: | Schetelig, J., Wreede, L.C. de, Gelder, M. van, Andersen, N.S., Moreno, C., Vitek, A., Karas, M., Michallet, M., Machaczka, M., Gramatzki, M., Beelen, D., Finke, J., Delgado, J., Volin, L., Passweg, J., Dreger, P., Henseler, A., Biezen, A. van, Bornhauser, M., Schonland, S.O., Kroger, N., CLL Subcomm, Chronic Malignancies Working Party |
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Přispěvatelé: | Interne Geneeskunde, MUMC+: MA Hematologie (9), RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy |
Jazyk: | angličtina |
Rok vydání: | 2017 |
Předmět: |
Oncology
Male medicine.medical_treatment Chronic lymphocytic leukemia Medizin Blood Donors DISEASE Targeted therapy RETROSPECTIVE ANALYSIS 0302 clinical medicine Risk Factors hemic and lymphatic diseases IDELALISIB VENETOCLAX Treatment Failure IBRUTINIB Age Factors Hematopoietic Stem Cell Transplantation Hematology Middle Aged Prognosis 3. Good health 030220 oncology & carcinogenesis Cohort SURVIVAL Female Adult medicine.medical_specialty Allogeneic transplantation Risk Assessment MECHANISMS 03 medical and health sciences Young Adult Sex Factors Internal medicine medicine Humans Transplantation Homologous Aged Transplantation Performance status Proportional hazards model business.industry CHRONIC LYMPHOCYTIC-LEUKEMIA STEM-CELL TRANSPLANTATION medicine.disease Leukemia Lymphocytic Chronic B-Cell Survival Analysis Surgery Graft-versus-host disease business FOLLOW-UP 030215 immunology |
Zdroj: | BONE MARROW TRANSPLANTATION r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau instname Bone Marrow Transplantation, 52(4), 552-560. Nature Publishing Group Bone Marrow Transplantation, 52(4), 552-560 |
ISSN: | 0268-3369 |
Popis: | For young patients with high-risk CLL, BTK-/PI3K-inhibitors or allogeneic stem cell transplantation (alloHCT) are considered. Patients with a low risk of non-relapse mortality (NRM) but a high risk of failure of targeted therapy may benefit most from alloHCT. We performed Cox regression analyses to identify risk factors for 2-year NRM and 5-year event-free survival (using EFS as a surrogate for long-term disease control) in a large, updated EBMT registry cohort (n = 694). For the whole cohort, 2-year NRM was 28% and 5-year EFS 37%. Higher age, lower performance status, unrelated donor type and unfavorable sex-mismatch had a significant adverse impact on 2-year NRM. Two-year NRM was calculated for good-and poor-risk reference patients. Predicted 2-year-NRM was 11 and 12% for male and female good-risk patients compared with 42 and 33% for male and female poor-risk patients. For 5-year EFS, age, performance status, prior autologous HCT, remission status and sex-mismatch had a significant impact, whereas del(17p) did not. The model-based prediction of 5-year EFS was 55% and 64%, respectively, for male and female good-risk patients. Good-risk transplant candidates with high-risk CLL and limited prognosis either on or after failure of targeted therapy should still be considered for alloHCT. |
Databáze: | OpenAIRE |
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