Myeloablative Regimens

Although encouraging results have been observed after high-dose chemotherapy alone followed by autologous SCT, in the vast majority of published data on SCT for CLL, the

Fig. 1. Autologous transplants in CLL survival: effect of interval diagnosis-transplant (adjusted for source of stem cell). Data from EBMT database.

Months

Fig. 2. CLL. MRC pilot study (D. Millighan): risk of molecular relapse after autotransplantation.

Months

Fig. 2. CLL. MRC pilot study (D. Millighan): risk of molecular relapse after autotransplantation.

myeloablative regimen included TBI because CLL cells are highly sensitive to irradiation. On the other hand, from the results of conventional therapy, it is unlikely that cytotoxic drugs alone can eradicate CLL (31,32). A retrospective analysis from the EBMT (13) also suggested that TBI-based regimens were superior to chemotherapy, although selection bias could not be discounted as a cause for the difference. Thus, TBI/cyclophosphamide still appears to be the gold standard for autografting of patients with CLL, although regimens employing high-dose chemotherapy alone may have similar efficacy.

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