- In patients with chronic lymphocytic leukemia (CLL), haploidentical allogeneic blood or marrow transplantation (allo-BMT) with posttransplant cyclophosphamide (PTCy) delivered outcomes consistent with those of patients receiving matched donor allo-BMT, with a low incidence of graft-versus-host disease (GVHD).
Why this matters
- Matched-sibling donor grafts are available to few patients in this setting.
- For other patients relying on matched unrelated donors or HLA haploidentical donors, transplant carries a risk for GVHD.
- Study to investigate nonmyeloablative (NMA) allo-BMT with PTCy in 64 patients with CLL.
- NMA comprised fludarabine, cyclophosphamide, and total body irradiation (TBI).
- Median patient age, 59 (range, 26-74) years.
- Funding: NIH; National Cancer Institute grants.
- 4-year OS: 52% (95% CI, 40%-68%).
- 4-year PFS: 37% (95% CI, 26%-54%).
- 6 patients experienced engraftment failure, among whom 5 had ≥20% marrow CLL involvement before transplant.
- 1-year cumulative incidence (CuI) of grade 2-4 acute GVHD: 27% (95% CI, 15%-38%).
- 2-year CuI of chronic GVHD: 17% (95% CI, 7%-26%).
- 3-year CuI of relapse: 36% (95% CI, 23%-49%).
- 3-year CuI of nonrelapse mortality: 24% (95% CI, 13%-36%).
- Limited sample size.