Abstract
Even with the availability of targeted drugs, allogeneic hematopoietic cell transplantation (allo-HCT) is the only therapy with curative potential for patients with CLL. Cure can be assessed by comparing long-term survival of patients to the matched general population. Using data from 2589 patients who received allo-HCT between 2000 and 2010, we used landmark analyses and methods from relative survival analysis to calculate excess mortality compared with an age-, sex- and calendar year-matched general population. Estimated event-free survival, overall survival and non-relapse mortality (NRM) 10 years after allo-HCT were 28% (95% confidence interval (CI), 25-31), 35% (95% CI, 32-38) and 40% (95% CI, 37-42), respectively. Patients who passed the 5-year landmark event-free survival (N=394) had a 79% probability (95% CI, 73-85) of surviving the subsequent 5 years without an event. Relapse and NRM contributed equally to treatment failure. Five-year mortality for 45- and 65-year-old reference patients who were event-free at the 5-year landmark was 8% and 47% compared with 3% and 14% in the matched general population, respectively. The prospect of long-term disease-free survival remains an argument to consider allo-HCT for young patients with high-risk CLL, and programs to understand and prevent late causes of failure for long-term survivors are warranted, especially for older patients.
| Original language | English |
|---|---|
| Pages (from-to) | 372-380 |
| Number of pages | 9 |
| Journal | Bone Marrow Transplantation |
| Volume | 52 |
| Issue number | 3 |
| Early online date | 12 Dec 2016 |
| DOIs | |
| Publication status | Published - 1 Mar 2017 |
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In: Bone Marrow Transplantation, Vol. 52, No. 3, 01.03.2017, p. 372-380.
Research output: Contribution to journal › Article › peer-review
TY - JOUR
T1 - Long-term survival of patients with CLL after allogeneic transplantation
T2 - A report from the European Society for Blood and Marrow Transplantation
AU - Van Gelder, M.
AU - De Wreede, L. C.
AU - Bornhäuser, M.
AU - Niederwieser, D.
AU - Karas, M.
AU - Anderson, N. S.
AU - Gramatzki, M.
AU - Dreger, P.
AU - Michallet, M.
AU - Petersen, E.
AU - Bunjes, D.
AU - Potter, M.
AU - Beelen, D.
AU - Cornelissen, J. J.
AU - Yakoub-Agha, I.
AU - Russell, N. H.
AU - Finke, J.
AU - Schoemans, H.
AU - Vitek, A.
AU - Urbano-Ispízua, null
AU - Blaise, D.
AU - Volin, L.
AU - Chevallier, P.
AU - Caballero, D.
AU - Putter, H.
AU - Van Biezen, A.
AU - Henseler, A.
AU - Schönland, S.
AU - Kröger, N.
AU - Schetelig, J.
AU - Ehninger, Gerhard
AU - Niederwieser, Dietger
AU - Jindra, Pavel
AU - Sengeloev, Henrik
AU - Gramatzki, Martin
AU - Dreger, Peter
AU - Petersen, Eefke
AU - Bunjes, Donald
AU - Potter, Michael
AU - Beelen, Dietrich
AU - Cornelissen, Jan
AU - Yakoub-Agha, Ibrahim
AU - Russell, Nigel
AU - Finke, Jürgen
AU - Schoemans, Hélène
AU - Vitek, Antonin
AU - Ispizua, Alvaro Urbano
AU - Blaise, Didier
AU - Volin, Liisa
AU - Arnold, Renate
AU - Chevallier, Patrice
AU - Caballero, Dolores
AU - Veelken, Joan Hendrik
AU - Mufti, Ghulam
AU - Milpied, Noel
AU - Benedetto, Bruno
AU - Schaap, Michel
AU - Leblond, Véronique
AU - Nikolousis, Manos
AU - Hallek, Michael
AU - Passweg, Jakob
AU - Ljungman, Per
AU - Masszi, Tamás
AU - Stelljes, Matthias
AU - Browne, Paul
AU - Glass, Bertram
AU - Espiga, Carlos Richard
AU - Bourhis, Jean Henri
AU - Roussy, Gustave
AU - Gribben, John
AU - Foa, Roberto
AU - Sierra, Jorge
AU - Mayer, Jiri
AU - Michallet, Mauricette
AU - Thomson, Kirsty
AU - Meijer, Ellen
AU - Blau, Wolfgang
AU - Holler, Ernst
AU - Bacigalupo, Andrea
AU - Guilhot, Francois
AU - Carlson, Kristina
AU - Zachée, Pierre
AU - Ifrah, Norbert
AU - Marín, José Rafael Cabrera
AU - Socié, Gerard
AU - McQuaker, Grant
AU - Cortelezzi, Agostino
AU - Lenhoff, Stig
AU - Tischer, Johanna
AU - Irrera, Giuseppe
AU - Fanin, Renato
AU - Beguin, Yves
AU - Nagler, Arnon
AU - Mackinnon, Stephen
AU - Itälä-Remes, Maija
AU - Deconinck, Eric
AU - Wulf, Gerald
AU - Corradini, Paolo
AU - Gilleece, Maria
AU - Wing, Bexley
AU - Peniket, Andy
AU - Ganser, Arnold
AU - Stuhler, Gernot
AU - Faber, Edgar
AU - Komarnicki, Michal
AU - Kanz, Lothar
AU - Brune, Mats
AU - Kröger, Nicolaus
AU - Lamy, Thierry
AU - Sanz, Miguel
AU - Kyrcz-Krzemien, Slawomira
AU - Orchard, Kim
AU - Hunter, Ann
AU - Sandstedt, Anna
AU - Fegueux, Nathalie
AU - Bandini, Giuseppe
AU - Robinson, Stephen
AU - Craddock, Charles
AU - Crawley, Charles
AU - Griskevicius, Laimonas
AU - Bloor, Adrian
AU - Reman, Oumédaly
AU - Hilgendorf, Inken
AU - Cannell, Paul
AU - Ciceri, Fabio
AU - Kalhs, Peter
AU - Sica, Simona
AU - Greinix, Hildegard
AU - Scimè, Rosanna
AU - Selleslag, Dominik
AU - Krüger, William
AU - Huynh, Anne
AU - Einsele, Herman
AU - Bittenbring, Jörg
AU - Olivieri, Attilio
AU - Hermine, Olivier
AU - Gedde-Dahl, Tobias
AU - Zsiros, Jozsef
AU - Guyotat, Dennis
AU - Cordonnier, Catherine
AU - Campos, Antonio
AU - Casini, Marco
AU - Martinelli, Giovanni
AU - Müller, Lutz Peter
AU - Van Imhoff, Gustaaf
AU - Neubauer, Andreas
AU - Lioure, Bruno
AU - Hamladji, Rose Marie
AU - Noens, Lucien
AU - Theobald, Matthias
AU - Salvi, Flavia
AU - Ram, Ron
AU - Poiré, Xavier
AU - Or, Reuven
AU - Chalandon, Yves
AU - Solano, Carlos
AU - Wilson, Keith
AU - Santasusana, Josep Maria Ribera
AU - Karakasis, Dimitrios
AU - Schäfer-Eckart, Kerstin
AU - Wahlin, Anders
AU - Mohty, Mohamad
AU - Velardi, Andrea
AU - Bron, Dominique
AU - Alegre, Adrián
AU - Cairoli, Roberto
AU - Marotta, Giuseppe
AU - Lange, Andrzej
AU - Narni, Franco
AU - Fauser, Axel
AU - Rambaldi, Alessandro
AU - Guillerm, Gaelle
AU - Heras, Inmaculada
AU - Snowden, John
AU - Wiktor-Jedrzejczak, Wieslaw
AU - Schanz, Urs
AU - Cahn, Jean Yves
AU - Abecasis, Manuel
AU - Kobbe, Guido
AU - Salim, Rahuman
AU - Junghanss, Christian
AU - Segel, Erik Kay
AU - Clement, L.
AU - Zák, Pavel
AU - Metzner, Bernd
AU - Espigado, Ildefonso
AU - Tilly, Herve
AU - Schroyens, Wilfried
AU - Favre, Claudio
AU - Russo, Domenico
AU - Gastl, Günther
AU - Bay, Jacques Olivier
AU - Alessandrino, Emilio Paolo
AU - Majolino, Ignazio
AU - Bosi, Alberto
AU - Zuckerman, Tsila
AU - Aljurf, Mahmoud
AU - Thomson, Jackie
AU - Pioltelli, Pietro
AU - Anagnostopoulos, Achilles
AU - Schouten, Harry
AU - Tholouli, Eleni
AU - Gurman, Gunhan
AU - Vural, Filiz
AU - Zver, Samo
AU - Muñiz, Soledad González
AU - Afanasyev, Boris
AU - Pohlreich, David
AU - Hellmann, Andrzej
AU - Rösler, Wolf
AU - Martin, Sonja
AU - Apperley, Jane
AU - Finnegan, Damian
AU - Renaud, Marc
AU - Nemet, Damir
AU - Culligan, Dominic
AU - Castagna, Luca
AU - Cascavilla, Nicola
AU - Koh, Mickey
AU - Chacón, Manuel Jurado
AU - Ozdogu, Hakan
AU - Spencer, Andrew
AU - Llamas, Carlos Vallejo
AU - Grasso, Mariella
AU - Lopez, Sebastian Garzon
AU - Benedetti, Fabio
AU - Deeren, Dries
AU - De Revel, Thierry
AU - Musso, Maurizio
AU - Halaburda, Kazimierz
AU - Sureda, Anna
AU - Angelucci, Emanuele
AU - Diez-Martin, José Luis
AU - Hunter, Hannah
AU - Koc, Yener
AU - Bordessoule, Dominique
AU - Fouillard, Loic
AU - Di Bartolomeo, Paolo
AU - Mazza, Patrizio
AU - Novitzky, Nicolas
AU - Peschel, Christian
AU - López, Jose Luis Bello
AU - Cascon, Maria Jesús Pascual
AU - Romeril, Kenneth R.
AU - Schots, Rik
AU - Brussel, Huis
AU - Koistinen, Pirjo
AU - Arcese, William
AU - Aktan, Melih
AU - Rodeghiero, Francesco
AU - Butler, Andrew
AU - Pizzuti, Michele
AU - Melpignano, Anglea
AU - Carella, Angelo Michele
AU - Valcárcel, David
AU - De Toledo Codina, José Sánchez
AU - Galieni, Piero
AU - Bader, Peter
AU - Hahn, null
AU - Cavanna, Luigi
AU - Sucak, Gülsan
AU - Broom, Angus J M
AU - García, Pedro Gomez
AU - Nicolas-Virelizier, Emmanuelle
AU - Rizzoli, Vittorio
AU - Witz, F.
AU - Potter, Mike
AU - Collin, Matthew
AU - Ringhoffer, Mark
AU - Kansu, Emin
AU - Martin, Hans
AU - Moraleda, José
AU - Pranger, Delphine
AU - Greil, Richard
AU - Bazarbachi, Ali
AU - Ozturk, Mustafa
AU - Fagioli, Franca
AU - Jantunen, Esa
AU - Yeshurun, Moshe
AU - Altuntas, Fevzi
AU - Bassan, Renato
AU - Rohrlich, Pierre Simon
AU - Jimenez, Santiago
AU - Glaisner, Sylvie
AU - Vinante, Orazio
AU - Clausen, Johannes
AU - López-Jiménez, Javier
AU - Theunissen, Koen
AU - Specchia, Giorgina
AU - Pavone, Vincenzo
AU - Krauter, Jürgen
AU - Edwards, David
AU - Rifón, Jose
AU - Everaus, Hele
AU - Da Prada, Gian Antonia
AU - Wattad, Mohammed
AU - Milone, Giuseppe
AU - Walewski, Jan
AU - Thieblemont, Catherine
AU - Nasa, Giorgio La
AU - Duchosal, Michel
AU - Ferrara, Felicetto
AU - Devidas, Alain
AU - Delmer, Alain
AU - Degos, Laurent
PY - 2017/3/1
Y1 - 2017/3/1
N2 - Even with the availability of targeted drugs, allogeneic hematopoietic cell transplantation (allo-HCT) is the only therapy with curative potential for patients with CLL. Cure can be assessed by comparing long-term survival of patients to the matched general population. Using data from 2589 patients who received allo-HCT between 2000 and 2010, we used landmark analyses and methods from relative survival analysis to calculate excess mortality compared with an age-, sex- and calendar year-matched general population. Estimated event-free survival, overall survival and non-relapse mortality (NRM) 10 years after allo-HCT were 28% (95% confidence interval (CI), 25-31), 35% (95% CI, 32-38) and 40% (95% CI, 37-42), respectively. Patients who passed the 5-year landmark event-free survival (N=394) had a 79% probability (95% CI, 73-85) of surviving the subsequent 5 years without an event. Relapse and NRM contributed equally to treatment failure. Five-year mortality for 45- and 65-year-old reference patients who were event-free at the 5-year landmark was 8% and 47% compared with 3% and 14% in the matched general population, respectively. The prospect of long-term disease-free survival remains an argument to consider allo-HCT for young patients with high-risk CLL, and programs to understand and prevent late causes of failure for long-term survivors are warranted, especially for older patients.
AB - Even with the availability of targeted drugs, allogeneic hematopoietic cell transplantation (allo-HCT) is the only therapy with curative potential for patients with CLL. Cure can be assessed by comparing long-term survival of patients to the matched general population. Using data from 2589 patients who received allo-HCT between 2000 and 2010, we used landmark analyses and methods from relative survival analysis to calculate excess mortality compared with an age-, sex- and calendar year-matched general population. Estimated event-free survival, overall survival and non-relapse mortality (NRM) 10 years after allo-HCT were 28% (95% confidence interval (CI), 25-31), 35% (95% CI, 32-38) and 40% (95% CI, 37-42), respectively. Patients who passed the 5-year landmark event-free survival (N=394) had a 79% probability (95% CI, 73-85) of surviving the subsequent 5 years without an event. Relapse and NRM contributed equally to treatment failure. Five-year mortality for 45- and 65-year-old reference patients who were event-free at the 5-year landmark was 8% and 47% compared with 3% and 14% in the matched general population, respectively. The prospect of long-term disease-free survival remains an argument to consider allo-HCT for young patients with high-risk CLL, and programs to understand and prevent late causes of failure for long-term survivors are warranted, especially for older patients.
UR - http://www.scopus.com/inward/record.url?scp=85014577257&partnerID=8YFLogxK
U2 - 10.1038/bmt.2016.282
DO - 10.1038/bmt.2016.282
M3 - Article
AN - SCOPUS:85014577257
SN - 0268-3369
VL - 52
SP - 372
EP - 380
JO - Bone Marrow Transplantation
JF - Bone Marrow Transplantation
IS - 3
ER -