Patients with chronic lymphocytic leukemia (CLL) or Richter’s transformation (RT) with disease progression after allogeneic stem-cell transplantation (SCT) have relatively good prognosis, and may benefit from salvage therapy, according to a recent study published online ahead of print in the Journal of Clinical Oncology.
“Allogeneic SCT induces long-term remission in a fraction of patients with high-risk CLL or RT,” noted the MD Anderson Cancer Center researchers led by Uri Rozovski, MD. “Our purpose was to determine the outcomes of patients whose disease progressed after allogeneic SCT.”
They retrospectively examined outcomes in 72 patients – 52 with CLL and 20 with RT – who had undergone allogeneic SCT from 1998 to 2011 and demonstrated disease progression. Median age at time of SCT was 58 years.
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The researchers found that two- and five-year survival rates were 67 and 38 percent for patients with CLL, and 36 and zero percent for patients with RT, respectively. Those who developed acute or chronic graft-versus-host disease had longer overall survival.
Upon multivariable analysis, chronic-graft-versus host disease and initial response to SCT predicted longer overall survival in patients.