Faculty Collaboration Database

Does total body irradiation conditioning improve outcomes of myeloablative human leukocyte antigen-identical sibling transplantations for chronic lymphocytic leukemia? Biol Blood Marrow Transplant 2014 Mar;20(3):421-4

Date

12/11/2013

Pubmed ID

24321745

Pubmed Central ID

PMC4026353

DOI

10.1016/j.bbmt.2013.11.032

Scopus ID

2-s2.0-84896865427 (requires institutional sign-in at Scopus site)   13 Citations

Abstract

An allogeneic hematopoietic cell transplantation from an HLA-identical donor after high-dose (myeloablative) pretransplantation conditioning is an effective therapy for some people with chronic lymphocytic leukemia (CLL). Because CLL is a highly radiosensitive cancer, we hypothesized that total body irradiation (TBI) conditioning regimens may be associated with better outcomes than those without TBI. To answer this, we analyzed data from 180 subjects with CLL receiving myeloablative doses of TBI (n = 126) or not (n = 54), who received transplants from an HLA-identical sibling donor between 1995 and 2007 and reported to the Center for International Blood & Marrow Transplant Research. At 5 years, treatment-related mortality was 48% (95% confidence interval [CI], 39% to 57%) versus 50% (95% CI, 36% to 64%); P = NS. Relapse rates were 17% (95% CI, 11% to 25%) versus 22% (95% CI, 11% to 35%); P = NS. Five-year progression-free survival and overall survival were 34% (95% CI, 26% to 43%) versus 28% (95% CI, 15% to 42%); P = NS and 42% (95% CI, 33% to 51%) versus 33% (95% CI, 19% to 48%); P = NS, respectively. The single most common cause of death in both cohorts was recurrent/progressive CLL. No variable tested in the multivariate analysis was found to significantly affect these outcomes, including having failed fludarabine. Within the limitations of this study, we found no difference in HLA-identical sibling transplantation outcomes between myeloablative TBI and chemotherapy pretransplantation conditioning in persons with CLL.

Author List

Sabloff M, Sobecks RM, Ahn KW, Zhu X, de Lima M, Brown JR, Inamoto Y, Holland HK, Aljurf MD, Laughlin MJ, Kamble RT, Hsu JW, Wirk BM, Seftel M, Lewis ID, Arora M, Alyea EP, Kalaycio ME, Cortes J, Maziarz RT, Gale RP, Saber W

Authors

Kwang Woo Ahn PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin
Wael Saber MD, MS Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Female
HLA Antigens
Hematopoietic Stem Cell Transplantation
Humans
Leukemia, Lymphocytic, Chronic, B-Cell
Male
Middle Aged
Myeloablative Agonists
Recurrence
Siblings
Survival Analysis
Transplantation Conditioning
Transplantation, Isogeneic
Treatment Outcome
Vidarabine
Whole-Body Irradiation