Allogeneic Transplantation for Chronic Lymphocytic Leukemia in the Age of Novel Treatment Strategies

[AussieNeil]

Given we currently have a few members going through bone marrow transplants, this review article in CancerNetwork by Mark-Alexander Schwarzbich, MD, Fabienne McClanahan, MD, PhD, and John Gribben, MD, DSc should be of interest:

cancernetwork.com/oncology-...

You may need (free) registration to view the article.

Note you may find the article rather confronting; stem cell transplants are rarely done for CLL and for good reasons. You are a better candidate for a transplant if you have been diagnosed at a (relatively) young age with CLL.

Some of the topics covered:

- Markers Predictive of Successful HSCT in CLL

- Management of Relapse After HSCT

- Alternative Immunochemotherapy-Based Treatment Options for Patients With TP53 Abnormalities

- Novel Treatment Options in CLL

- Which Patients Should Be Offered HSCT in the Era of Novel Agents?

(Check out table 2, which gives an overview of the advantages and disadvantages on Novel Agents and Haematopoietic Stem Cell Transplants)

Neil

Photo: Sometimes it's necessary for a new fence post or a new bone marrow...

[hanskloss]

I am hearing from number of sources that BM transplants are usually not as successful in CLL as in acute leukemia...there are complications, relapses, rejections etc...

Wonder if anyone else has head anything about this?

[Cllcanada Top Poster CURE Hero in reply to hanskloss]

I think graft verses host disease, GVHD...is the major problem in allogeneic transplants in CLL, but the newer RIC approaches are better and the treatment mortality has dropped to around 15% -30% two years post procedure.

It is still a 'last hope treatment' for the younger patient with high risk genetics

Here is a recent summation by Dr. P. Dreger, world leader in HSCT knowledge in CLL

bloodjournal.org/content/12...

[Justasheet1 in reply to Cllcanada]

Chris,

Not a very optimistic article and 2 years old.

Jeff