Written in Blood
related (40%) or unrelated (60%) donors.
Reduced-intensity conditioning regimens
consisted of: fludarabine 30 mg/m 2 and
cyclophosphamide 500 mg/m 2 once-daily
from day six to day two pre-transplant. Pa-
tients with unrelated donors also received
antithymocyte globulin 10 mg/kg daily
from day four to day one pre-transplant.
The CLL3X trial included adult
patients (age range = 18-65 years
old) with high-risk CLL (defined as
refractoriness or early relapse [within
12 months] after treatment with a
purine analogue-containing regimen;
relapse after autologous HCT; or
progressive disease in the presence of
an unfavorable genetic constellation).
Patients were excluded if they had
Richter transformation. Twenty-four
percent of patients were refractory to
alloHCT, and 35 percent had a TP53
mutation.
Long-term results were available for 37
patients: five died because of complications of
CLL (n=3), chronic graft-versus-host disease
(GVHD; n=1), and secondary cancer (n=1).
Three patients experienced disease recurrence
at 6.9, 9.3, and 9.7 years following alloHCT.
At six years of follow-up, 37 of the 90
patients who received HCT (41%) had
died, including nine of 12 patients who
received in vivo T-cell depletion with
alemtuzumab.
After a median follow-up of 9.7 years
(range = 0.6-15.2 years), rates of 10-year
overall survival (OS) and progression-
free survival (PFS) for all 90 allografted
patients were 51 percent (95% CI 40-62)
and 34 percent (59% CI 23-44), respec-
tively (see TABLE ).
The authors identified the following
as important risk factors for long-term
outcomes: