Abstract
To identify potential barriers to reduced-intensity conditioning (RIC) allogeneic stem cell transplantation (ASCT) in patients with chronic lymphocytic leukemia (CLL) we performed a retrospective review of patients referred for transplant consultation at our center. Of the 209 patients evaluated, a substantial proportion of patients who were appropriate candidates for RIC-ASCT were unable to attain disease control to proceed (18.3%) with this therapy.
Highlights
Chronic lymphocytic leukemia (CLL) is the most common hematologic malignancy in the Western world, representing 30% of leukemia [1]
Utilization of new combinations of chemotherapeutic agents, as well as the introduction of biologic agents, and the identification of prognostic markers that have led to better risk stratification and more tailored treatments have led to longer remissions, but CLL is still considered incurable outside the transplant setting [2]
A comprehensive assessment of certain genetic and molecular markers, including fluorescent in-situ hybridization (FISH) has shown that outcomes of fludarabine-based therapies can be predicted by these markers, and that alternative therapies should be considered in certain patients with high risk markers, including del (17p13.1) and del (11q22.3) [4]
Summary
Chronic lymphocytic leukemia (CLL) is the most common hematologic malignancy in the Western world, representing 30% of leukemia [1]. Utilization of new combinations of chemotherapeutic agents, as well as the introduction of biologic agents, and the identification of prognostic markers that have led to better risk stratification and more tailored treatments have led to longer remissions, but CLL is still considered incurable outside the transplant setting [2]. Treatment for young and otherwise healthy patients has traditionally involved fludarabine, typically in combination with other agents [3]. Reduced-intensity conditioning (RIC) allogeneic stem cell transplant (ASCT) is one such option. In spite of RIC ASCT being the only potentially curative option available for CLL, relatively few patients who are referred for transplant evaluation eventually go on to receive one. The purpose of this study was to quantify how many patients are evaluated versus how many eventually receive a transplant, to evaluate differences between patients who received a transplant and those who did not, and to attempt to elucidate why this therapeutic option is not pursued more frequently
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
