Where Does Allogeneic Stem Cell Transplantation Fit in the Treatment of Chronic Lymphocytic Leukemia?

Overview

Journal Curr Hematol Malig Rep

Publisher Current Science

Specialties Hematology
Oncology

Date 2015 Feb 6

PMID 25651976

Citations 3

Authors

Peter Dreger

Emili Montserrat

Affiliations

Soon will be listed here.

Abstract

Allogeneic hematopoietic stem cell transplantation (alloHSCT) has been considered as the treatment of choice for patients with high-risk chronic lymphocytic leukemia (CLL) (i.e., refractory to purine analogs, short response (<24 months) to intensive treatments, and/or presence of 17p/TP53 abnormalities). Currently, new and highly effective therapeutic agents targeting BCR-mediated intracellular signal transduction have been incorporated into the CLL treatment armamentarium. These signal transduction inhibitors (STI) will change the algorithms of high-risk CLL (HR-CLL) management. Despite the limited body of evidence, there is sufficient rationale for withholding alloHSCT in patients with 17p-/TP53mut CLL in first remission. In contrast, the perspectives of patients with relapsed 17p-/TP53mut CLL remain uncertain even if responding to STI. The same accounts for patients with HR-CLL progressing under STI. In both scenarios, it is reasonable to consider alloHSCT, ideally after response to alternative STI regimens.

Citing Articles

Allogeneic hematopoietic cell transplantation outcomes in patients with Richter's transformation.

Kim H, Baker P, Parry E, Davids M, Alyea E, Ho V Haematologica. 2021; 106(12):3219-3222.

PMID: 34435483 PMC: 8634179. DOI: 10.3324/haematol.2021.279033.

Allogeneic hematopoietic cell transplantation after prior targeted therapy for high-risk chronic lymphocytic leukemia.

Kim H, Shaughnessy C, Rai S, Reynolds C, Ho V, Cutler C Blood Adv. 2020; 4(17):4113-4123.

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[Reduced intensity conditioning allogeneic hematopoietic stem cell transplantation in chronic lymphocytic leukemia (CLL) patients with the aberration of p53 gene].

Wang L, Miao K, Fan L, Xu J, Wu H, Li J Zhonghua Xue Ye Xue Za Zhi. 2016; 37(4):308-12.

PMID: 27093994 PMC: 7343084. DOI: 10.3760/cma.j.issn.0253-2727.2016.04.012.

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