TCT 2021: Update on Transplant Outcomes for CLL in Australasia
Posted: Tuesday, February 16, 2021
At the 2021 Transplantation & Cellular Therapy Meetings (TCT), Luani Barge, MChD, BSc, of Greenslopes Hospital, Brisbane, Australia, and colleagues examined trends over the past decade after allogeneic hematopoietic stem cell transplantation (HSCT) in patients with chronic lymphocytic leukemia (CLL) in Australia and New Zealand; they attempted to identify factors that may be predictive of overall and progression-free survival. The investigators reported improvement in nonrelapse mortality and graft-versus-host disease, although no significant changes in overall or progression-free survival (Abstract 142).
The data from 153 patients with CLL who underwent allogeneic HSCT were collected from the Australasian Bone Marrow Transplant Recipient Registry. Outcomes were compared between 2009 to 2013 and 2014 to 2018.
Patients' median age at transplantation was 55 years, and the median time from diagnosis to transplantation was 5.7 years. Reduced intensity or nonmyeloablative conditioning was administered to 84% of patients, 73% of whom did not receive T-cell–depleting therapy. The median follow-up was 5.9 years, and acute graft-versus-host disease of grade II to IV affected 39% of individuals. At 5 years, the cumulative incidence of chronic graft-versus-host disease was 65%. Median overall survival and progression-free survival were 4.3 and 2.6 years, respectively. Infection, graft-versus-host disease, and persistent disease or relapse were the cause of death in 43%, 40%, and 24% of participants, respectively.
According to a multivariate analysis, inferior overall survival seemed to be independently associated with active disease at the time of transplantation. Donor, age, T-cell–depleting therapy, and myeloablative conditioning did not seem to have any notable impact. However, a univariate analysis suggested an association between myeloablative conditioning and improved progression-free survival.
Between 2009 and 2013, 97 patients underwent transplantation; between 2014 and 2018, 56 underwent transplantation. No statistical difference in performance status, donor, patient age, use of T-cell–depleting therapy or myeloablative conditioning, or disease status was discovered. A notable improvement in 5-year nonrelapse mortality was demonstrated, and graft-versus-host disease was reduced. There was no significant difference found for progression-free and overall survival or relapse rates.
Disclosure: For full disclosures of the study authors, visit tct.confex.com.
