Kronik Lenfositik Lösemi’de Allojeneik Kök Hücre Nakli Deneyimi

Abstract

Objective: Chronic lymphocytic leukemia (CLL) is the most common leukemia in adults. In patients with poor prognosis, allogeneic stem cell transplantation (ASCT)treatment is an alternative. ASCT indications in CLL: Patients with refractory disease or early relapse (shorter than 12 months) after treatment with purine analogues, relapse within 24 months after achieving response with purine analogues/autologous stem cell transplantation or in patients with p53 anomalies. However, the indications have been revised after novel therapies reached successful results in relapsed/refractory setting. In this study, we aimed to evaluate our CLL patients who underwent ASCT. Materials and Methods: Seven high-risk patients with CLL who were diagnosed at Ankara University School of Medicine Department of Hematology between 2007-2015and subsequently underwent ASCT at our Bone Marrow Transplantation Unit were evaluated retrospectively. Results: In post-transplant disease evaluation, 4/7 patients (57%) achieved complete remission and 3/7 patients (43%) did not respond. Acute graft versus host disease was detected in 2/7 (29%) patients while 3/7 (43%) patients were diagnosed with chronic graft versus host disease. Overall survival was 69 months (range, 19-121 months). Conclusion: Sustained response rates can be achieved with ASCT in high-risk CLL patients in long-term.

Keywords

• Allogeneic Stem Cell Transplantation
• Chronic Lymphocytic Leukemia
• Leukemia

Kronik Lenfositik Lösemi’de Allojeneik Kök Hücre Nakli Deneyimi

Abstract

Amaç: Kronik lenfositik lösemi (KLL) erișkinlerde en sık görülen lösemidir. Tedavi seçeneği kısıtlıkötü prognozu olan hastalarda, allojeneik kök hücre nakli (AKHN) tedavi alternatifidir. KLL’de allojeneik nakil; tedaviye yanıtısız veya pürin analogları sonrasında erken nükste (12 aydan kısa), pürin analogları veya otolog kök hücre nakli ile yanıtaulașmıș hastalarda 24 ay içinde nüks gelișiminde veya p53 anomalisi olanlarda önerilmekteyken günümüzde hedefe yönelik tedavilerin bașarısıyla AKHN endikasyonları güncellenmiștir. Bu çalıșmada, allojeneik kök hücre nakli yapılan KLL hastalarımızın değerlendirilmesi amaçlanmıștır. Gereç ve Yöntem: 2007-2015 tarihleri arasında Ankara Üniversitesi Tıp Fakültesi Hematoloji Bilim Dalı’nda tanı alan ve sonrasında Kök Nakil Ünitemizde AKHN yapılmıș yüksek riskli 7 KLL hastası retrospektif olarak değerlendirilmiștir. Bulgular: Nakil sonrası hastalık değerlendirmesinde; 4/7 hastada (%57) tam remisyon, 3/7 hastada (%43) yanıtsızlık gözlenmiștir. Akut graft versus host hastalığı 2/7 (%29)hastada görülürken, 3/7 (%43) hasta kronik graft versus host hastalığı tanısı almıștır. Genel sağkalım 69 aydır (aralık, 19-121 ay). Sonuç: Yüksek riskli KLL hastalarında AKHN ile uzun süreli ve sürdürülebilir yanıt oranlarına ulașılabilmektedir.

Keywords

• Allojeneik Kök Hücre Nakli
• Kronik Lenfositik Lösemi

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