Chronic Lymphocytic Leukemia (CLL)
Chronic lymphocytic leukemia (CLL) is primarily an adult disease, with a median age at diagnosis of 71 years. In the United States, about 15,000 people are diagnosed with CLL each year, of which about 60% are male. [1]
CLL is generally an indolent disease, and treatment does not usually begin until a patient has bothersome or serious symptoms such as lymphadenopathy, anemia, or thrombocytopenia.
Chemotherapy and/or immunotherapy is the usual front-line therapy. Hematopoietic cell transplantation (HCT), usually allogeneic, is indicated when a patient with CLL relapses after chemotherapy and remission times are short or disease risk factors indicate high risk-disease. [2,3] Approximately 80% of transplants in CLL are allogeneic transplants. [4]
Outcomes
Review outcomes for allogeneic cell transplantation in patients with CLL below. View additional CLL outcome slides showing demographic data and transplant trends.
Data in this section have been prepared by CIBMTR® (Center for International Blood and Marrow Transplant Research), our research program.
Figure 1. CLL Survival, Allogeneic HCT, by Donor Type
Download slide "CLL Survival, Allogeneic HCT, by Donor Type"
Figure 2. CLL Survival Over Time, Unrelated HCT
Referral Timing Guidelines
These guidelines highlight disease categories that include patients at risk for disease progression and who should be referred for a consultation for autologous or allogeneic cell transplantation. [5]
Transplant Consultation Guidelines: CLL
- High-risk cytogenetics or molecular features (e.g., del(11q) or del(17p); ZAP70, CD38 positivity; unmutated Ig VH mutational status, complex karyotype)
- Poor initial response
- Short initial remission
- Chemotherapy- or targeted therapy-resistant
- Richter's transformation
Download as a slide (PPT)
View complete Referral Timing Guidelines
References
- Miller KD, Siegel RL, Lin CC, et al. Cancer treatment and survivorship statistics, 2016. CA Cancer J Clin. 2016; 66(4): 271-289. Access
- Lu K, Wang X. Therapeutic advancement of chronic lymphocytic leukemia. J Hematol Oncol. 2012; 5:55. Access
- Kharfan-Dabaja MA, Kumar A, Hamadani M, et al. 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. 2016; Epub September 19. Access
- D'Souza A, Fretham C. Current Uses and Outcomes of Hematopoietic Cell Transplantation (HCT): CIBMTR Summary Slides, 2017. Available at: http://www.cibmtr.org
- NMDP/Be The Match and ASBMT Recommended Timing for Transplant Consultation, 2018. Download (PDF)