Allogeneic hematopoietic stem cell transplant with reduced-intensity conditioning for chronic lymphocytic leukemia in Sweden: does donor T-cell engraftment 3 months after transplant predict survival?

Leuk Lymphoma. 2012 Sep;53(9):1699-705. doi: 10.3109/10428194.2012.666661. Epub 2012 Mar 16.

Abstract

Thirty-eight adult patients with chronic lymphocytic leukemia (CLL) underwent reduced-intensity conditioning (RIC) allogeneic stem cell transplant (allo-SCT) in Sweden between 1999 and 2007. The cumulative incidences of acute graft-versus-host disease (GVHD) grades II-IV and chronic GVHD were 29% and 47%, respectively. Rates of non-relapse mortality, progression-free survival (PFS) and overall survival (OS) were 18%, 47% and 74% at 1 year, and 21%, 25% and 45% at 5 years, respectively. T-cell chimerism after transplant was measured in 31 out of 34 patients (91%) surviving beyond day +100. Seventeen patients achieved >90% donor T-cell engraftment at 3 months after allo-SCT and, compared with the 12 patients with ≤90% donor T-cell engraftment, they showed favorable PFS at 1 year (82% vs. 33%, p =0.002) and better long-term PFS and OS (p =0.002 and 0.046, respectively). Donor T-cell engraftment of >90% at 3 months after RIC allo-SCT for CLL seems to predict favorable short-term and long-term outcome.

MeSH terms

  • Acute Disease
  • Adult
  • Chronic Disease
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Graft Survival
  • Graft vs Host Disease / diagnosis
  • Hematopoietic Stem Cell Transplantation / methods*
  • Humans
  • Leukemia, Lymphocytic, Chronic, B-Cell / therapy*
  • Male
  • Middle Aged
  • Neoplasm, Residual / diagnosis
  • Prognosis
  • Recurrence
  • Sweden
  • T-Lymphocytes / metabolism
  • T-Lymphocytes / transplantation
  • Time Factors
  • Transplantation Conditioning / methods*
  • Transplantation, Homologous
  • Treatment Outcome