Clinical Practice Recommendations for Use of Allogeneic Hematopoietic Cell Transplantation in Chronic Lymphocytic Leukemia on Behalf of the Guidelines Committee of the American Society for Blood and Marrow Transplantation

被引:63
作者
Kharfan-Dabaja, Mohamed A. [1 ,2 ]
Kumar, Ambuj [3 ]
Hamadani, Mehdi [4 ]
Stilgenbauer, Stephan [5 ]
Ghia, Paolo [6 ,7 ,8 ]
Anasetti, Claudio [1 ,2 ]
Dreger, Peter [9 ]
Montserrat, Emili [10 ]
Perales, Miguel-Angel [11 ]
Alyea, Edwin P. [12 ]
Awan, Farrukh T. [13 ]
Ayala, Ernesto [1 ,2 ]
Barrientos, Jacqueline C. [14 ]
Brown, Jennifer R. [12 ]
Castro, Januario E. [15 ]
Furman, Richard R. [16 ]
Gribben, John [17 ]
Hill, Brian T. [18 ]
Mohty, Mohamad [19 ,20 ]
Moreno, Carol [21 ]
O'Brien, Susan [22 ]
Pavletic, Steven Z. [23 ]
Pinilla-Ibarz, Javier [2 ,24 ]
Reddy, Nishitha M. [25 ]
Sorror, Mohamed [26 ,27 ]
Bredeson, Christopher [28 ,29 ]
Carpenter, Paul [26 ,27 ]
Savani, Bipin N. [25 ]
机构
[1] H Lee Moffitt Canc Ctr & Res Inst, Dept Blood & Marrow Transplantat, Tampa, FL USA
[2] Univ S Florida, Morsani Coll Med, Dept Oncol Sci, Tampa, FL USA
[3] Univ S Florida, Coll Med, Program Comparat Effectiveness Res, Tampa, FL USA
[4] Med Coll Wisconsin, Div Hematol Oncol, Milwaukee, WI 53226 USA
[5] Univ Ulm, Internal Med 3, Ulm, Germany
[6] IRCCS San Raffaele Hosp, Dept Oncohaematol, Milan, Italy
[7] IRCCS San Raffaele Hosp, Div Expt Oncol, Milan, Italy
[8] Univ Vita Salute San Raffaele, Milan, Italy
[9] Heidelberg Univ, Dept Med 5, Heidelberg, Germany
[10] Univ Barcelona, Hosp Clin Barcelona, Dept Hematol, Barcelona, Spain
[11] Mem Sloan Kettering Canc Ctr, Dept Med, Adult Bone Marrow Transplant Serv, 1275 York Ave, New York, NY 10021 USA
[12] Dana Farber Canc Inst, Med Oncol, Boston, MA 02115 USA
[13] Ohio State Univ, Ctr Comprehens Canc, Dept Internal Med, Div Hematol, Columbus, OH 43210 USA
[14] Hofstra Northwell Sch Med, CLL Res & Treatment Program, New Hyde Pk, NY USA
[15] Univ Calif San Diego, Moores Canc Ctr, La Jolla, CA 92093 USA
[16] Weill Cornell Med Coll, Div Hematol Oncol, New York, NY USA
[17] Queen Mary Univ London, John Vane Canc Ctr, Barts Canc Inst, Charterhouse Sq, London, England
[18] Cleveland Clin, Dept Hematol & Med Oncol, Taussig Canc Inst, Cleveland, OH 44106 USA
[19] Univ Paris 06, St Antoine Hosp, Dept Haematol, Paris, France
[20] INSERM, UMRs938, Paris, France
[21] Hosp Santa Creu St Pau, Barcelona, Spain
[22] Univ Calif Irvine, Chao Family Comprehens Canc Ctr, Orange, CA 92668 USA
[23] NCI, NIH, Expt Transplantat & Immunol Branch, Bethesda, MD 20892 USA
[24] H Lee Moffitt Canc Ctr & Res Inst, Dept Malignant Hematol, Tampa, FL USA
[25] Vanderbilt Univ, Sch Med, Dept Med, Div Hematol Oncol, Nashville, TN 37212 USA
[26] Univ Washington, Sch Med, Dept Med, Seattle, WA 98195 USA
[27] Fred Hutchinson Canc Res Ctr, Div Clin Res, 1124 Columbia St, Seattle, WA 98104 USA
[28] Ottawa Hosp, Blood & Marrow Transplant Program, Ottawa, ON, Canada
[29] Ottawa Hosp Res Inst, Ottawa, ON, Canada
关键词
Chronic lymphocytic leukemia; Allogeneic hematopoietic cell transplantation; BCR inhibitors; BCL-2; inhibitors; REDUCED-INTENSITY; FLOW-CYTOMETRY; 17P DELETION; FOLLOW-UP; MUTATIONAL STATUS; PERIPHERAL-BLOOD; RICHTER SYNDROME; BONE-MARROW; SINGLE-ARM; CLL;
D O I
10.1016/j.bbmt.2016.09.013
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
We sought to establish clinical practice recommendations to redefine the role of allogeneic hematopoietic cell transplantation (allo-HCT) for patients with chronic lymphocytic leukemia (CLL) in an era of highly active targeted therapies. We performed a systematic review to identify prospective randomized controlled trials comparing allo-HCT against novel therapies for treatment of CLL at various disease stages. In the absence of such data, we invited physicians with expertise in allo-HCT and/or CLL to participate in developing these recommendations. We followed the Grading of Recommendations Assessment, Development and Evaluation methodology. For standard-risk CLL we recommend allo-HCT in the absence of response or if there is evidence of disease progression after B cell receptor (BCR) inhibitors. For high-risk CLL an allo-HCT is recommended after failing 2 lines of therapy and showing an objective response to BCR inhibitors or to a clinical trial. It is also recommended for patients who fail to show an objective response or progress after BCR inhibitors and receive BCL-2 inhibitors, regardless of whether an objective response is achieved. For Richter transformation, we recommend allo-HCT upon demonstration of an objective response to anthracycline-based chemotherapy. A reduced-intensity conditioning regimen is recommended whenever indicated. These recommendations high-light the rapidly changing treatment landscape of CLL. Newer therapies have disrupted prior paradigms, and allo-HCT is now relegated to later stages of relapsed or refractory CLL. (C) 2016 American Society for Blood and Marrow Transplantation.
引用
收藏
页码:2117 / 2125
页数:9
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