"Results of Stem Cell Transplantation in Chronic Lymphocytic Leukemia in Egyptian Patients نتائج زرع النخاع في حالات سرطان الدم الليمفاوي المزمن في المرضى المصريين"

       Cairo  National Cancer Institute  Medical oncology       M.Sc  2009             "Dr. Mohamed Abd El-Mooti Mohamed

Prof. Dr. Nasr Mohamed Ali Al-Lahloubi"                 "Although CLL cases mostly are indolent, however none of the available drugs in treatment of CLL is curative, so it was important to discuss the role and results of stem cell transplantation in CLL cases.

Our study aims at assessing the eligibility criteria for SCT, and the outcome of this procedure in CLL patients, through including patients with CLL who underwent stem cell transplantation by National Cancer Institute BMT team.

The study includes ten patients, five of them underwent allogenic stem cell transplantation and five underwent autologous stem cell transplantation.

Three patients (OR: 60%) of the allogenic group are alive while two are dead; two of the alive patients are in CR (40%) while one is relapsed (PR: 20%) with DFS 40%, TRM occurred in one patient (20%) due to renal failure and was after 44 days of BMT, GVHD occurs in two cases (40%); in one case it was grade III acute GVHD, however the other case developed extensive chronic GVHD.

In the autologous group, all the three alive patients are in CR (60%), with DFS 60%, and TRM occurred in one patient (20%) due to septic shock at day +8.

As regard data from our study and other studies discussing the role of BMT in CLL cases, future approaches for the management of this disease must consider the balance between the increased morbidity and mortality of SCT in CLL with the curative potential that these approaches potentially offer in the setting of the improvements in outcome that can now be seen using chemoimmunotherapy.

Finally we conclude that HSTC in CLL case is recommended in clinical trials only for high risk chemo-resistant and too young patients however we should consider the new era of chemoimmunotherapy with high promising overall response, and questions remain regarding appropriate patient selection for consideration of SCT and the timing of SCT in the clinical course of the disease.

In conclusion, SCT in CLL patients is still investigational and controlled trials should be encouraged to document the value of this procedure in these patients."