Does total body irradiation conditioning improve outcomes of myeloablative human leukocyte antigen-identical sibling transplantations for chronic lymphocytic leukemia?

Mitchell Sabloff, Ronald M. Sobecks, Kwang Woo Ahn, Xiaochun Zhu, Marcos de Lima, Jennifer R. Brown, Yoshihiro Inamoto, H. Kent Holland, Mahmoud D. Aljurf, Mary J. Laughlin, Rammurti T. Kamble, Jack W. Hsu, Baldeep M. Wirk, Matthew Seftel, Ian D. Lewis, Mukta Arora, Edwin P. Alyea, Matt E. Kalaycio, Jorge Cortes, Richard T. MaziarzRobert Peter Gale, Wael Saber

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

An allogeneic hematopoietic cell transplantation from an HLA-identical donor after high-dose (myeloablative) pretransplantation conditioning is an effective therapy for some people with chronic lymphocytic leukemia (CLL). Because CLL is a highly radiosensitive cancer, we hypothesized that total body irradiation (TBI) conditioning regimens may be associated with better outcomes than those without TBI. To answer this, we analyzed data from 180 subjects with CLL receiving myeloablative doses of TBI (n=126) or not (n=54), who received transplants from an HLA-identical sibling donor between 1995 and 2007 and reported to the Center for International Blood & Marrow Transplant Research. At 5years, treatment-related mortality was 48% (95% confidence interval [CI], 39% to 57%) versus 50% (95% CI, 36% to 64%); P= NS. Relapse rates were 17% (95% CI, 11% to 25%) versus 22% (95% CI, 11% to 35%); P= NS. Five-year progression-free survival and overall survival were 34% (95% CI, 26% to 43%) versus 28% (95% CI, 15% to 42%); P= NS and 42% (95% CI, 33% to 51%) versus 33% (95% CI, 19% to 48%); P= NS, respectively. The single most common cause of death in both cohorts was recurrent/progressive CLL. No variable tested in the multivariate analysis was found to significantly affect these outcomes, including having failed fludarabine. Within the limitations of this study, we found no difference in HLA-identical sibling transplantation outcomes between myeloablative TBI and chemotherapy pretransplantation conditioning in persons with CLL.

Original languageEnglish (US)
Pages (from-to)421-424
Number of pages4
JournalBiology of Blood and Marrow Transplantation
Volume20
Issue number3
DOIs
StatePublished - Mar 2014

Keywords

  • Chronic lymphocytic leukemia
  • Conditioning
  • Myeloablative
  • Total body irradiation

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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    Sabloff, M., Sobecks, R. M., Ahn, K. W., Zhu, X., de Lima, M., Brown, J. R., Inamoto, Y., Holland, H. K., Aljurf, M. D., Laughlin, M. J., Kamble, R. T., Hsu, J. W., Wirk, B. M., Seftel, M., Lewis, I. D., Arora, M., Alyea, E. P., Kalaycio, M. E., Cortes, J., ... Saber, W. (2014). Does total body irradiation conditioning improve outcomes of myeloablative human leukocyte antigen-identical sibling transplantations for chronic lymphocytic leukemia? Biology of Blood and Marrow Transplantation, 20(3), 421-424. https://doi.org/10.1016/j.bbmt.2013.11.032