Indications for allogeneic stem cell transplantation in chronic lymphocytic leukemia: the EBMT transplant consensus

Leukemia. 2007 Jan;21(1):12-7. doi: 10.1038/sj.leu.2404441. Epub 2006 Nov 16.

Abstract

The aim of this project was to identify situations where allogeneic stem cell transplantation (allo-SCT) might be considered as a preferred treatment option for patients with B-cell chronic lymphocytic leukemia (CLL). Based on a MEDLINE search and additional sources, a consented proposal was drafted, refined and approved upon final discussion by an international expert panel. Key elements of the consensus are (1) allo-SCT is a procedure with evidence-based efficacy in poor-risk CLL; (2) although definition of 'poor-risk CLL' requires further investigation, allo-SCT is a reasonable treatment option for younger patients with (i) non-response or early relapse (within 12 months) after purine analogues, (ii) relapse within 24 months after having achieved a response with purine-analogue-based combination therapy or autologous transplantation, and (iii) patients with p53 abnormalities requiring treatment; and (3) optimum transplant strategies may vary according to distinct clinical situations and should be defined in prospective trials. This is the first attempt to define standard indications for allo-SCT in CLL. Nevertheless, whenever possible, allo-SCT should be performed within disease-specific prospective clinical protocols in order to continuously refine transplant indications according to new developments in risk assessment and treatment of CLL.

Publication types

  • Consensus Development Conference
  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Evidence-Based Medicine
  • Humans
  • Leukemia, Lymphocytic, Chronic, B-Cell / pathology
  • Leukemia, Lymphocytic, Chronic, B-Cell / physiopathology
  • Leukemia, Lymphocytic, Chronic, B-Cell / therapy*
  • Middle Aged
  • Prognosis
  • Recurrence
  • Risk Factors
  • Stem Cell Transplantation*
  • Time Factors