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Posted by on Sep 19, 2021 in Leukemia | 0 comments

In a nutshell

The study aimed to investigate whether reduced-intensity conditioning (RIC) hemopoietic stem cell transplantation (HSCT) improves the outcomes of patients with chronic lymphocytic leukemia (CLL) with and without Richter's transformation (RT). 

This study concluded that this treatment may be suitable in early remission courses for these patients.  

Some background

Allogeneic HSCT (allo-HSCT) may potentially cure patients with CLL and RT (CLL-RT). Allo-HSCT involves transplanting healthy cells from a donor to the patient. It aims to replace cells lost during cancer treatment and to boost the immune system. A conditioning regimen is a powerful chemotherapy combination that aims to destroy cancer cells before allo-HSCT. 

10% of patients with CLL develop a RT. This means cancer cells become more aggressive and transform into a different type of cancer such as non-Hodgkin lymphoma (NHL). Patients with CLL-RT have a poorer outcome. 

Some patients cannot tolerate high-dose chemotherapy as a conditioning regimen. For these patients, RIC, which uses lower intensity chemotherapy, is used. The outcomes of patients with CLL with or without RT undergoing RIC followed by allo-HSCT are unknown. 

Methods & findings

This study involved 58 patients with CLL. These included 23 patients with CLL-RT. All patients underwent RIC allo-HSCT. Patients were then followed for an average of 89 months. 

All patients had achieved successful engraftment (when the donated cells start to grow and make healthy blood cells). After 5 years, 40% of patients were alive without cancer worsening and 58% were alive. 

After 2 years, 36% of patients had developed long-term graft-versus-host disease (GVHD). GVHD is a complication of allo-HSCT where the transplanted cells attack the patient. 

Patients with and without RT had similar outcomes.

The bottom line

This study concluded that RIC-HSCT may be a good treatment option for patients with CLL with or without RT. 

The fine print

This study had a small number of participants. Different conditioning regimens were used. This may affect the results. Larger studies are needed. 

Published By :

Blood advances

Date :

Jul 27, 2021

Original Title :

Reduced-intensity conditioning hematopoietic stem cell transplantation for chronic lymphocytic leukemia and Richter’s transformation.

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