Allogeneic Haploidentical Blood or Marrow Transplantation with Post-Transplantation Cyclophosphamide in Chronic Lymphocytic Leukemia

Suman Paul, Hua Ling Tsai, Patrick Lowery, Ephraim J. Fuchs, Leo Luznik, Javier Bolaños-Meade, Lode J. Swinnen, Satish Shanbhag, Nina Wagner-Johnston, Ravi Varadhan, Richard F. Ambinder, Richard J. Jones, Douglas E. Gladstone

Research output: Contribution to journalArticle

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 languageEnglish (US)
JournalBiology of Blood and Marrow Transplantation
DOIs
StateAccepted/In press - Jan 1 2019

Fingerprint

B-Cell Chronic Lymphocytic Leukemia
Cyclophosphamide
Transplantation
Bone Marrow
Graft vs Host Disease
Confidence Intervals
Disease-Free Survival
Survival
Incidence
Therapeutics

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 journalArticle

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