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Blood, 15 February 2006, Vol. 107, No. 4, pp. 1724-1730. Prepublished online as a Blood First Edition Paper on October 20, 2005; DOI 10.1182/blood-2005-08-3372. This Article Full Text Full Text (PDF) All Versions of this Article: 2005-08-3372v1 107/4/1724    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Delgado, J. Articles by Milligan, D. W. Search for Related Content PubMed PubMed Citation Articles by Delgado, J. Articles by Milligan, D. W. Related Collections Neoplasia Transplantation Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  TRANSPLANTATION Results of alemtuzumab-based reduced-intensity allogeneic transplantation for chronic lymphocytic leukemia: a British Society of Blood and Marrow Transplantation Study Julio Delgado, Kirsty Thomson, Nigel Russell, Joanne Ewing, Wendy Stewart, Gordon Cook, Stephen Devereux, Richard Lovell, Rajesh Chopra, David I. Marks, Stephen Mackinnon, and Donald W. Milligan From the Birmingham Heartlands Hospital, Birmingham; Royal Free and University College Hospitals, London; Nottingham City Hospital, Nottingham; St James's University Hospital, Leeds; King's College Hospital, London; Christie Hospital, Manchester; and Bristol Royal Children's Hospital, Bristol, United Kingdom. We report results in 41 consecutive patients with chronic lymphocytic leukemia (CLL) who underwent allogeneic hematopoietic cell transplantation (HCT) after fludarabine, melphalan, and alemtuzumab conditioning. Donors were 24 HLA-matched siblings and 17 unrelated volunteers, 4 of them mismatched with recipients. All but 3 patients had initial hematologic recovery, but 5 more patients had secondary graft failure. Median intervals to neutrophil (greater than 0.5 x 109/L) and platelet (greater than 20 x 109/L) recovery were 14 days (range, 9-30 days) and 11 days (range, 8-45 days), respectively. Eleven (27%) patients had relapses and received escalated donor lymphocyte infusions, but only 3 of them had sustained responses. Acute and chronic graft-versus-host disease (GVHD) was observed in 17 (41%) and 13 (33%) patients, respectively. Seventeen (41%) patients have died, 5 of progressive disease. The 2-year overall survival and transplantation-related mortality (TRM) rates were 51% (95% confidence interval [CI], 33%-69%) and 26% (95% CI, 14%-46%), respectively. The alemtuzumabbased regimen was feasible and effective in patients with CLL with a relatively low rate of GVHD. However, TRM remains relatively high as a result of a variety of viral and fungal infections. Studies are ongoing to address the efficacy of reduced doses of alemtuzumab in this group of immunosuppressed patients. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: J. G. Gribben The Role of Stem Cell Transplantation in Chronic Lymphocytic Leukemia ASCO Educational Book, January 1, 2008; 2008(1): 291 - 296. [Abstract] [Full Text] [PDF] M. L. Sorror, B. E. Storer, D. G. Maloney, B. M. Sandmaier, P. J. Martin, and R. Storb Outcomes after allogeneic hematopoietic cell transplantation with nonmyeloablative or myeloablative conditioning regimens for treatment of lymphoma and chronic lymphocytic leukemia Blood, January 1, 2008; 111(1): 446 - 452. [Abstract] [Full Text] [PDF] J. M. Rowe and A. H. Goldstone How I treat acute lymphocytic leukemia in adults Blood, October 1, 2007; 110(7): 2268 - 2275. [Abstract] [Full Text] [PDF] C. G. Brunstein, D. J. Weisdorf, T. DeFor, J. N. Barker, J. Tolar, J.-A. H. van Burik, and J. E. Wagner Marked increased risk of Epstein-Barr virus-related complications with the addition of antithymocyte globulin to a nonmyeloablative conditioning prior to unrelated umbilical cord blood transplantation Blood, October 15, 2006; 108(8): 2874 - 2880. [Abstract] [Full Text] [PDF]

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