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J Clin Oncol. 2005 May 20;23(15):3433-8. Epub 2005 Apr 4.

Allogeneic stem-cell transplantation may overcome the adverse prognosis of unmutated VH gene in patients with chronic lymphocytic leukemia.

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  • 1Department of Hematology, Institute of Hematology and Oncology, Hospital Clínic, Villarroel, 170, 08036 Barcelona, Spain.

Abstract

PURPOSE:

To investigate whether allogeneic stem-cell transplantation (allo-SCT) may overcome the negative impact of unmutated VH genes in the outcome of patients with chronic lymphocytic leukemia (CLL).

PATIENTS AND METHODS:

We analyzed the outcome of patients who underwent SCT according to their VH mutational status.

RESULTS:

Thirty-four patients (14 allo-SCT and 20 autologous SCT [auto-SCT]) presented unmutated VH genes and 16 patients presented mutated VH genes (nine allo-SCT and seven auto-SCT). Tumoral burden pre-SCT was significantly higher in the allo-SCT patients independent of the VH mutational status. The risk of relapse was significantly higher after auto-SCT (5-year risk, 61%; 95% CI, 44% to 84%) than after allo-SCT (5-year risk 12%, 95% CI, 3% to 44%; P < .05). In the unmutated group, 13 of 20 auto-SCT and two of 14 allo-SCT patients experienced disease progression, with a risk of relapse at 5 years of 66% (95% CI, 48% to 93%) v 17% (95% CI, 5% to 60%), respectively (P = .01).

CONCLUSION:

These results show that allo-SCT may overcome the unfavorable effect of unmutated VH genes in patients with CLL.

PMID:
15809449
[PubMed - indexed for MEDLINE]
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