Abstract
Allogeneic blood or marrow transplantation (allo-BMT) remains the only treatment for chronic lymphocytic leukemia (CLL) with curative potential. Although post-transplantation cyclophosphamide (PTCy) reduces allo-BMT toxicity by decreasing the risk of graft-versus-host disease (GVHD), its effect on CLL allo-BMT outcomes is unknown. We studied 64 consecutive patients with CLL who underwent nonmyeloablative (NMA) haploidentical allo-BMT at Johns Hopkins Sidney Kimmel Comprehensive Cancer Center. In this cohort, the 4-year overall survival was 52% (95% confidence interval [CI], 40% to 68%), and progression-free survival was 37% (95% CI, 26% to 54%). Six patients experienced engraftment failure. PTCy prophylaxis was associated with a modest cumulative incidence of 1-year grade II-IV acute GVHD (27%; %95% CI, 15% to 38%) and %%%2-year chronic GVHD (17%; 95% CI, 7% to 26%). We demonstrate that NMA haploidentical allo-BMT with PTCy is a safe and effective treatment option.
| Original language | English (US) |
|---|---|
| Journal | Biology of Blood and Marrow Transplantation |
| DOIs | |
| State | Accepted/In press - Jan 1 2019 |
Fingerprint
Keywords
- Allogeneic blood or marrow transplantation
- Chronic lymphocytic leukemia
- Graft-versus-host-disease
- Haploidentical
- Post-transplantation cyclophosphamide
ASJC Scopus subject areas
- Hematology
- Transplantation
Cite this
Allogeneic Haploidentical Blood or Marrow Transplantation with Post-Transplantation Cyclophosphamide in Chronic Lymphocytic Leukemia. / Paul, Suman; Tsai, Hua Ling; Lowery, Patrick; Fuchs, Ephraim J.; Luznik, Leo; Bolaños-Meade, Javier; Swinnen, Lode J.; Shanbhag, Satish; Wagner-Johnston, Nina; Varadhan, Ravi; Ambinder, Richard F.; Jones, Richard J.; Gladstone, Douglas E.
In: Biology of Blood and Marrow Transplantation, 01.01.2019.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Allogeneic Haploidentical Blood or Marrow Transplantation with Post-Transplantation Cyclophosphamide in Chronic Lymphocytic Leukemia
AU - Paul, Suman
AU - Tsai, Hua Ling
AU - Lowery, Patrick
AU - Fuchs, Ephraim J.
AU - Luznik, Leo
AU - Bolaños-Meade, Javier
AU - Swinnen, Lode J.
AU - Shanbhag, Satish
AU - Wagner-Johnston, Nina
AU - Varadhan, Ravi
AU - Ambinder, Richard F.
AU - Jones, Richard J.
AU - Gladstone, Douglas E.
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Allogeneic blood or marrow transplantation (allo-BMT) remains the only treatment for chronic lymphocytic leukemia (CLL) with curative potential. Although post-transplantation cyclophosphamide (PTCy) reduces allo-BMT toxicity by decreasing the risk of graft-versus-host disease (GVHD), its effect on CLL allo-BMT outcomes is unknown. We studied 64 consecutive patients with CLL who underwent nonmyeloablative (NMA) haploidentical allo-BMT at Johns Hopkins Sidney Kimmel Comprehensive Cancer Center. In this cohort, the 4-year overall survival was 52% (95% confidence interval [CI], 40% to 68%), and progression-free survival was 37% (95% CI, 26% to 54%). Six patients experienced engraftment failure. PTCy prophylaxis was associated with a modest cumulative incidence of 1-year grade II-IV acute GVHD (27%; %95% CI, 15% to 38%) and %%%2-year chronic GVHD (17%; 95% CI, 7% to 26%). We demonstrate that NMA haploidentical allo-BMT with PTCy is a safe and effective treatment option.
AB - Allogeneic blood or marrow transplantation (allo-BMT) remains the only treatment for chronic lymphocytic leukemia (CLL) with curative potential. Although post-transplantation cyclophosphamide (PTCy) reduces allo-BMT toxicity by decreasing the risk of graft-versus-host disease (GVHD), its effect on CLL allo-BMT outcomes is unknown. We studied 64 consecutive patients with CLL who underwent nonmyeloablative (NMA) haploidentical allo-BMT at Johns Hopkins Sidney Kimmel Comprehensive Cancer Center. In this cohort, the 4-year overall survival was 52% (95% confidence interval [CI], 40% to 68%), and progression-free survival was 37% (95% CI, 26% to 54%). Six patients experienced engraftment failure. PTCy prophylaxis was associated with a modest cumulative incidence of 1-year grade II-IV acute GVHD (27%; %95% CI, 15% to 38%) and %%%2-year chronic GVHD (17%; 95% CI, 7% to 26%). We demonstrate that NMA haploidentical allo-BMT with PTCy is a safe and effective treatment option.
KW - Allogeneic blood or marrow transplantation
KW - Chronic lymphocytic leukemia
KW - Graft-versus-host-disease
KW - Haploidentical
KW - Post-transplantation cyclophosphamide
UR - http://www.scopus.com/inward/record.url?scp=85076556779&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85076556779&partnerID=8YFLogxK
U2 - 10.1016/j.bbmt.2019.11.008
DO - 10.1016/j.bbmt.2019.11.008
M3 - Article
C2 - 31730920
AN - SCOPUS:85076556779
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
SN - 1083-8791
ER -