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
Por:
Kharfan-Dabaja, MA, Kumar, A, Hamadani, M, Stilgenbauer, S, Ghia, P, Anasetti, C, Dreger, P, Montserrat, E, Perales, MA, Alyea, EP, Awan, FT, Ayala, E, Barrientos, JC, Brown, JR, Castro, JE, Furman, RR, Gribben, J, Hill, BT, Mohty, M, Moreno, C, O'Brien, S, Pavletic, SZ, Pinilla-Ibarz, J, Reddy, NM, Sorror, M, Bredeson, C, Carpenter, P, Savani, BN
Publicada:
1 dic 2016
Resumen:
We sought to establish clinical practice recommendations to redefine the role of allogeneic hematopoietic cell transplantation (allo-HCT) for patients with chronic lymphocytic leukemia (CLL) in an era of highly active targeted therapies. We performed a systematic review to identify prospective randomized controlled trials comparing allo-HCT against novel therapies for treatment of CLL at various disease stages. In the absence of such data, we invited physicians with expertise in allo-HCT and/or CLL to participate in developing these recommendations. We followed the Grading of Recommendations Assessment, Development and Evaluation methodology. For standard-risk CLL we recommend allo-HCT in the absence of response or if there is evidence of disease progression after B cell receptor (BCR) inhibitors. For high-risk CLL an allo-HCT is recommended after failing 2 lines of therapy and showing an objective response to BCR inhibitors or to a clinical trial. It is also recommended for patients who fail to show an objective response or progress after BCR inhibitors and receive BCL-2 inhibitors, regardless of whether an objective response is achieved. For Richter transformation, we recommend allo-HCT upon demonstration of an objective response to anthracycline-based chemotherapy. A reduced-intensity conditioning regimen is recommended whenever indicated. These recommendations high-light the rapidly changing treatment landscape of CLL. Newer therapies have disrupted prior paradigms, and allo-HCT is now relegated to later stages of relapsed or refractory CLL. (C) 2016 American Society for Blood and Marrow Transplantation.
Filiaciones:
Kharfan-Dabaja, MA:
H Lee Moffitt Canc Ctr & Res Inst, Dept Blood & Marrow Transplantat, Tampa, FL USA
Univ S Florida, Morsani Coll Med, Dept Oncol Sci, Tampa, FL USA
Kumar, A:
Univ S Florida, Coll Med, Program Comparat Effectiveness Res, Tampa, FL USA
Hamadani, M:
Med Coll Wisconsin, Div Hematol Oncol, Milwaukee, WI 53226 USA
Stilgenbauer, S:
Univ Ulm, Internal Med 3, Ulm, Germany
Ghia, P:
IRCCS San Raffaele Hosp, Dept Oncohaematol, Milan, Italy
IRCCS San Raffaele Hosp, Div Expt Oncol, Milan, Italy
Univ Vita Salute San Raffaele, Milan, Italy
Anasetti, C:
H Lee Moffitt Canc Ctr & Res Inst, Dept Blood & Marrow Transplantat, Tampa, FL USA
Univ S Florida, Morsani Coll Med, Dept Oncol Sci, Tampa, FL USA
Dreger, P:
Heidelberg Univ, Dept Med 5, Heidelberg, Germany
Montserrat, E:
Univ Barcelona, Hosp Clin Barcelona, Dept Hematol, Barcelona, Spain
Perales, MA:
Mem Sloan Kettering Canc Ctr, Dept Med, Adult Bone Marrow Transplant Serv, 1275 York Ave, New York, NY 10021 USA
Alyea, EP:
Dana Farber Canc Inst, Med Oncol, Boston, MA 02115 USA
Awan, FT:
Ohio State Univ, Ctr Comprehens Canc, Dept Internal Med, Div Hematol, Columbus, OH 43210 USA
Ayala, E:
H Lee Moffitt Canc Ctr & Res Inst, Dept Blood & Marrow Transplantat, Tampa, FL USA
Univ S Florida, Morsani Coll Med, Dept Oncol Sci, Tampa, FL USA
Barrientos, JC:
Hofstra Northwell Sch Med, CLL Res & Treatment Program, New Hyde Pk, NY USA
Brown, JR:
Dana Farber Canc Inst, Med Oncol, Boston, MA 02115 USA
Castro, JE:
Univ Calif San Diego, Moores Canc Ctr, La Jolla, CA 92093 USA
Furman, RR:
Weill Cornell Med Coll, Div Hematol Oncol, New York, NY USA
Gribben, J:
Queen Mary Univ London, John Vane Canc Ctr, Barts Canc Inst, Charterhouse Sq, London, England
Hill, BT:
Cleveland Clin, Dept Hematol & Med Oncol, Taussig Canc Inst, Cleveland, OH 44106 USA
Mohty, M:
Univ Paris 06, St Antoine Hosp, Dept Haematol, Paris, France
INSERM, UMRs938, Paris, France
Moreno, C:
Hosp Santa Creu St Pau, Barcelona, Spain
O'Brien, S:
Univ Calif Irvine, Chao Family Comprehens Canc Ctr, Orange, CA 92668 USA
Pavletic, SZ:
NCI, NIH, Expt Transplantat & Immunol Branch, Bethesda, MD 20892 USA
Pinilla-Ibarz, J:
Univ S Florida, Morsani Coll Med, Dept Oncol Sci, Tampa, FL USA
H Lee Moffitt Canc Ctr & Res Inst, Dept Malignant Hematol, Tampa, FL USA
Reddy, NM:
Vanderbilt Univ, Sch Med, Dept Med, Div Hematol Oncol, Nashville, TN 37212 USA
Sorror, M:
Univ Washington, Sch Med, Dept Med, Seattle, WA 98195 USA
Fred Hutchinson Canc Res Ctr, Div Clin Res, 1124 Columbia St, Seattle, WA 98104 USA
Bredeson, C:
Ottawa Hosp, Blood & Marrow Transplant Program, Ottawa, ON, Canada
Ottawa Hosp Res Inst, Ottawa, ON, Canada
Carpenter, P:
Univ Washington, Sch Med, Dept Med, Seattle, WA 98195 USA
Fred Hutchinson Canc Res Ctr, Div Clin Res, 1124 Columbia St, Seattle, WA 98104 USA
Savani, BN:
Vanderbilt Univ, Sch Med, Dept Med, Div Hematol Oncol, Nashville, TN 37212 USA
Green Accepted, Hybrid Gold
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