HIGH-INCIDENCE OF RELAPSE AFTER AUTOLOGOUS STEM-CELL TRANSPLANTATION FOR B-CELL CHRONIC LYMPHOCYTIC-LEUKEMIA OR SMALL LYMPHOCYTIC LYMPHOMA

Background: High-dose therapy followed by autologous stem-cell transpl antation (autoSCT) induces complete remissions in the majority of pati ents with advanced B-cell chronic lymphocytic leukemia or small lympho cytic lymphoma (B-CLL). However, the long-term utility of this therapy for B-CLL is unknown. Patients and methods: Sixteen previously treate d patients with B-CLL were transplanted using autologous blood (n = 13 ) or bone marrow (n = 3). The median age of the patients was 49 years (range 44-60 years), and the median number of prior chemotherapy regim ens was two. Patients were eligible for transplantation if they had ch emosensitive disease and no morphologic evidence of malignant cells in the graft. Preparative regimens included cyclophosphamide and total-b ody-irradiation, with or without cytarabine, or BEAC. Results: All pat ients engrafted and achieved a complete remission posttransplant. Ten patients were alive at a median of 41 months (range 22-125 months), an d five were disease-free. Eight patients have relapsed and six have di ed (three from progressive malignancy). The projected three-year overa ll survival, failure-free survival and relapse rates were 68%, 37%, an d 56%? respectively. Conclusions. AutoSCT for advanced B-CLL is associ ated with a high relapse rate. Whether this therapy can prolong life o r produce cures is uncertain.