Two international prestigious groups have participated in this paper: first, the European Research Initiative on CLL (ERIC), chaired by Dr. Emili Montserrat; and second, the European Society for Blood and Marrow Transplantation (EBMT), led by Dr. Peter Dreger.
The Hematology Department at Hospital Clínic is renowned worldwide for both the study of chronic lymphocytic leukemia (CLL) and the development of new techniques for hematopoietic stem cell transplantation. Until now, treatment for patients with CLL with the worst prognosis was allogeneic bone marrow transplantation. As a result of favorable outcome data reported for new drugs to treat the disease - BCR signal inhibitors and antagonists of BCL-2-, specialists, and patients themselves, are reconsidering which is the best therapeutic strategy to control CLL. The recommendations published in Blood advise that all patients with high-risk CLL should be treated first with the new drugs available. If they have a good response to this treatment, then it should be considered whether to perform a bone marrow transplantation or continue with the pharmacological treatment.
Thus, when advising one treatment over the other, both the risks and benefits of transplantation should be considered, which are widely analyzed in this work that will certainly be a paradigm shift in treatment of this leukemia.
Chronic Lymphocytic Leukemia
Chronic lymphocytic leukemia (CLL) is the most common form of leukemia in western countries and represents 30-40% of all leukemias. It is a neoplasia of lymphocytes, a type of white blood cells, and is characterized by a slow and progressive increase of these cells in blood, bone marrow and other organs. Its cause is unknown and the prognosis very heterogeneous, so that some patients have a long clinical evolution with a normal lifespan, whereas others follow a progressive course with an average survival of 5-8 years. This is the reason why treatment must be in accordance with the characteristics of the patient and the risk the disease represents in each case.
Dreger P, Schetelig J, Andersen N, Corradini P, van Gelder M, Gribben J, Kimby E, Michallet M, Moreno C, Stilgenbauer S, Montserrat E.
Blood.2014 Oct 9.pii: blood-2014-07-586826.