Efficacy of cisplatin-based immunochemotherapy plus alloSCT in high-risk chronic lymphocytic leukemia: final results of a prospective multicenter phase 2 HOVON study

M van Gelder, MH van Oers, Wendimagegn Ghidey Alemayehu, Martine Testroote, Jan Cornelissen, ME Chamuleau, P Zachee, M Hoogendoorn, M Nijland, EJ Petersen, A Beeker, GJ Timmers, L Verdonck, M Westerman, O de Weerdt, AP Kater

Research output: Contribution to journalArticleAcademicpeer-review

11 Citations (Scopus)

Abstract

Allogeneic stem cell transplantation (alloSCT) remains the only curative option for CLL patients. Whereas active disease at the time of alloSCT predicts poor outcome, no standard remission-induction regimen exists. We prospectively assessed outcome after cisplatin-containing immune-chemotherapy (R-DHAP) followed by alloSCT in 46 patients (median age 58 years) fulfilling modified European Society for Blood and Marrow Transplantation (EBMT) CLL Transplant Consensus criteria being refractory to or relapsed (R/R) <1 year after fludarabine or <2 years after fludarabine-based immunochemotherapy or R/R with del(17p). Twenty-nine patients received. >= 3 cycles of R-DHAP and sixteen <3 cycles (4 because of disease progression, 8 for toxicity and 4 toxic deaths). Overall rate of response to R-DHAP was 58%, 31 (67%) proceeded to alloSCT after conditioning with fludarabine and 2 Gy TBI. Twenty (65%) remained free from progression at 2 years after alloSCT, including 17 without minimal residual disease. Intention-to-treat 2-year PFS and overall survival of the 46 patients were 42 and 51% (35.5 months median follow-up); del(17p) or fludarabine refractoriness had no impact. R-DHAP followed by alloSCT is a reasonable treatment to be considered for high-risk CLL patients without access or resistance to targeted therapies.
Original languageUndefined/Unknown
Pages (from-to)799-806
Number of pages8
JournalBone Marrow Transplantation
Volume51
Issue number6
DOIs
Publication statusPublished - 2016

Cite this