Chronic lymphocytic leukemia (CLL)
Transplant advances and outcomes
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 a common front-line treatment. Hematopoietic cell transplantation (HCT) 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] Allogeneic HCT remains the only curative option for patients with CLL. [2] Approximately 80% of transplants in CLL are allogeneic transplants. [4]
Recommended timing for transplant consultation
- Resistance or intolerance to BTK inhibitors and BCL2 inhibitors
- Richter's transformation
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 and ASTCT Recommended Timing for Transplant Consultation. Download PDF
- National Comprehensive Cancer Network. Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma. (Version 1.2023). Access