Mohamed A Kharfan-Dabaja1, Ali Bazarbachi. 1. Division of Hematology-Oncology and Bone Marrow Transplantation, Department of Internal Medicine, American University of Beirut, Beirut, Lebanon. MK143@aub.edu.lb
Abstract
BACKGROUND: Allogeneic hematopoietic cell transplantation (allo-HCT) remains the only known treatment modality that currently offers a potential cure to patients with chronic lymphocytic leukemia (CLL). A better understanding of the role of adoptive immunotherapy and its consequent bona fide graft-vs-leukemia (GVL) effect has resulted in a reduction of the ablative intensity and toxicity of preparative allo-HCT regimens. METHODS: The authors review the published data of reduced-intensity conditioning (RIC) allo-HCT in patients with CLL. RESULTS: RIC allo-HCT has reduced the transplant associated morbidity and mortality of the procedure and has consequently broadened applicability of allo-HCT to patients with CLL who are generally of more advanced age (> 60 years) and who often have associated comorbidities. CONCLUSIONS: Published literature supports the use of RIC allo-HCT for these patients once a suitable donor is identified, provided they fulfill acceptable consensus criteria for hematopoietic stem cell allografting. Several studies have shown that T-cell-replete RIC allo-HCT is also capable of overcoming the adverse effect of poor prognostic factors in CLL such as del(17p), unmutated IgVH, or ZAP-70 expression. Continued clinical trials to identify the optimal regimen for RIC allo-HCT for patients with CLL are warranted.
BACKGROUND: Allogeneic hematopoietic cell transplantation (allo-HCT) remains the only known treatment modality that currently offers a potential cure to patients with chronic lymphocytic leukemia (CLL). A better understanding of the role of adoptive immunotherapy and its consequent bona fide graft-vs-leukemia (GVL) effect has resulted in a reduction of the ablative intensity and toxicity of preparative allo-HCT regimens. METHODS: The authors review the published data of reduced-intensity conditioning (RIC) allo-HCT in patients with CLL. RESULTS: RIC allo-HCT has reduced the transplant associated morbidity and mortality of the procedure and has consequently broadened applicability of allo-HCT to patients with CLL who are generally of more advanced age (> 60 years) and who often have associated comorbidities. CONCLUSIONS: Published literature supports the use of RIC allo-HCT for these patients once a suitable donor is identified, provided they fulfill acceptable consensus criteria for hematopoietic stem cell allografting. Several studies have shown that T-cell-replete RIC allo-HCT is also capable of overcoming the adverse effect of poor prognostic factors in CLL such as del(17p), unmutated IgVH, or ZAP-70 expression. Continued clinical trials to identify the optimal regimen for RIC allo-HCT for patients with CLL are warranted.
Authors: M A Kharfan-Dabaja; M Labopin; A Bazarbachi; R M Hamladji; D Blaise; G Socié; B Lioure; A Bermudez; L Lopez-Corral; R Or; W Arcese; N Fegueux; A Nagler; M Mohty Journal: Bone Marrow Transplant Date: 2014-06-30 Impact factor: 5.483
Authors: Mohamed A Kharfan-Dabaja; Ambuj Kumar; Mehdi Hamadani; Stephan Stilgenbauer; Paolo Ghia; Claudio Anasetti; Peter Dreger; Emili Montserrat; Miguel-Angel Perales; Edwin P Alyea; Farrukh T Awan; Ernesto Ayala; Jacqueline C Barrientos; Jennifer R Brown; Januario E Castro; Richard R Furman; John Gribben; Brian T Hill; Mohamad Mohty; Carol Moreno; Susan O'Brien; Steven Z Pavletic; Javier Pinilla-Ibarz; Nishitha M Reddy; Mohamed Sorror; Christopher Bredeson; Paul Carpenter; Bipin N Savani Journal: Biol Blood Marrow Transplant Date: 2016-09-19 Impact factor: 5.742
Authors: Mohamed A Kharfan-Dabaja; Claudio Anasetti; Hugo F Fernandez; Janelle Perkins; Jose L Ochoa-Bayona; Joseph Pidala; Lia E Perez; Ernesto Ayala; Teresa Field; Melissa Alsina; Taiga Nishihori; Frederick Locke; Javier Pinilla-Ibarz; Marcie Tomblyn Journal: Biol Blood Marrow Transplant Date: 2013-04-28 Impact factor: 5.742
Authors: Julio C Chavez; Mohamed A Kharfan-Dabaja; Jongphil Kim; Binglin Yue; Samir Dalia; Javier Pinilla-Ibarz; Claudio Anasetti; Frederick L Locke Journal: Leuk Res Date: 2014-04-28 Impact factor: 3.156