Results of alemtuzumab-based reduced-intensity allogeneic transplantation for chronic lymphocytic leukemia: a British Society of Blood and Marrow Transplantation Study.

2.50
Hdl Handle:
http://hdl.handle.net/10541/72684
Title:
Results of alemtuzumab-based reduced-intensity allogeneic transplantation for chronic lymphocytic leukemia: a British Society of Blood and Marrow Transplantation Study.
Authors:
Delgado, Julio; Thomson, Kirsty J; Russell, Nigel; Ewing, Joanne; Stewart, Wendy; Cook, Gordon; Devereux, Stephen; Lovell, Richard; Chopra, Rajesh; Marks, David I; Mackinnon, Stephen; Milligan, Donald W
Abstract:
We report results in 41 consecutive patients with chronic lymphocytic leukemia (CLL) who underwent allogeneic hematopoietic cell transplantation (HCT) after fludarabine, melphalan, and alemtuzumab conditioning. Donors were 24 HLA-matched siblings and 17 unrelated volunteers, 4 of them mismatched with recipients. All but 3 patients had initial hematologic recovery, but 5 more patients had secondary graft failure. Median intervals to neutrophil (greater than 0.5 x 10(9)/L) and platelet (greater than 20 x 10(9)/L) recovery were 14 days (range, 9-30 days) and 11 days (range, 8-45 days), respectively. Eleven (27%) patients had relapses and received escalated donor lymphocyte infusions, but only 3 of them had sustained responses. Acute and chronic graft-versus-host disease (GVHD) was observed in 17 (41%) and 13 (33%) patients, respectively. Seventeen (41%) patients have died, 5 of progressive disease. The 2-year overall survival and transplantation-related mortality (TRM) rates were 51% (95% confidence interval [CI], 33%-69%) and 26% (95% CI, 14%-46%), respectively. The alemtuzumabbased regimen was feasible and effective in patients with CLL with a relatively low rate of GVHD. However, TRM remains relatively high as a result of a variety of viral and fungal infections. Studies are ongoing to address the efficacy of reduced doses of alemtuzumab in this group of immunosuppressed patients.
Affiliation:
Department of Hematology, Birmingham Heartlands Hospital, Birmingham, B9 5SS, United Kingdom.
Citation:
Results of alemtuzumab-based reduced-intensity allogeneic transplantation for chronic lymphocytic leukemia: a British Society of Blood and Marrow Transplantation Study. 2006, 107 (4):1724-30 Blood
Journal:
Blood
Issue Date:
15-Feb-2006
URI:
http://hdl.handle.net/10541/72684
DOI:
10.1182/blood-2005-08-3372
PubMed ID:
16239425
Type:
Article
Language:
en
ISSN:
0006-4971
Appears in Collections:
All Paterson Institute for Cancer Research

Full metadata record

DC FieldValue Language
dc.contributor.authorDelgado, Julio-
dc.contributor.authorThomson, Kirsty J-
dc.contributor.authorRussell, Nigel-
dc.contributor.authorEwing, Joanne-
dc.contributor.authorStewart, Wendy-
dc.contributor.authorCook, Gordon-
dc.contributor.authorDevereux, Stephen-
dc.contributor.authorLovell, Richard-
dc.contributor.authorChopra, Rajesh-
dc.contributor.authorMarks, David I-
dc.contributor.authorMackinnon, Stephen-
dc.contributor.authorMilligan, Donald W-
dc.date.accessioned2009-07-07T10:26:22Z-
dc.date.available2009-07-07T10:26:22Z-
dc.date.issued2006-02-15-
dc.identifier.citationResults of alemtuzumab-based reduced-intensity allogeneic transplantation for chronic lymphocytic leukemia: a British Society of Blood and Marrow Transplantation Study. 2006, 107 (4):1724-30 Blooden
dc.identifier.issn0006-4971-
dc.identifier.pmid16239425-
dc.identifier.doi10.1182/blood-2005-08-3372-
dc.identifier.urihttp://hdl.handle.net/10541/72684-
dc.description.abstractWe report results in 41 consecutive patients with chronic lymphocytic leukemia (CLL) who underwent allogeneic hematopoietic cell transplantation (HCT) after fludarabine, melphalan, and alemtuzumab conditioning. Donors were 24 HLA-matched siblings and 17 unrelated volunteers, 4 of them mismatched with recipients. All but 3 patients had initial hematologic recovery, but 5 more patients had secondary graft failure. Median intervals to neutrophil (greater than 0.5 x 10(9)/L) and platelet (greater than 20 x 10(9)/L) recovery were 14 days (range, 9-30 days) and 11 days (range, 8-45 days), respectively. Eleven (27%) patients had relapses and received escalated donor lymphocyte infusions, but only 3 of them had sustained responses. Acute and chronic graft-versus-host disease (GVHD) was observed in 17 (41%) and 13 (33%) patients, respectively. Seventeen (41%) patients have died, 5 of progressive disease. The 2-year overall survival and transplantation-related mortality (TRM) rates were 51% (95% confidence interval [CI], 33%-69%) and 26% (95% CI, 14%-46%), respectively. The alemtuzumabbased regimen was feasible and effective in patients with CLL with a relatively low rate of GVHD. However, TRM remains relatively high as a result of a variety of viral and fungal infections. Studies are ongoing to address the efficacy of reduced doses of alemtuzumab in this group of immunosuppressed patients.en
dc.language.isoenen
dc.subjectCancer Antibodiesen
dc.subjectLeukaemiaen
dc.subject.meshAdult-
dc.subject.meshAged-
dc.subject.meshAntibodies, Monoclonal-
dc.subject.meshAntibodies, Neoplasm-
dc.subject.meshAntineoplastic Agents-
dc.subject.meshAntineoplastic Combined Chemotherapy Protocols-
dc.subject.meshFollow-Up Studies-
dc.subject.meshGraft vs Host Disease-
dc.subject.meshHistocompatibility Testing-
dc.subject.meshHumans-
dc.subject.meshLeukemia, Lymphocytic, Chronic, B-Cell-
dc.subject.meshMiddle Aged-
dc.subject.meshStem Cell Transplantation-
dc.subject.meshSurvival Analysis-
dc.subject.meshTime Factors-
dc.subject.meshTissue Donors-
dc.subject.meshTransplantation Chimera-
dc.subject.meshTransplantation, Homologous-
dc.subject.meshTreatment Failure-
dc.subject.meshTreatment Outcome-
dc.titleResults of alemtuzumab-based reduced-intensity allogeneic transplantation for chronic lymphocytic leukemia: a British Society of Blood and Marrow Transplantation Study.en
dc.typeArticleen
dc.contributor.departmentDepartment of Hematology, Birmingham Heartlands Hospital, Birmingham, B9 5SS, United Kingdom.en
dc.identifier.journalBlooden

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