One patient (UPN 6) was transplanted after having attained MRD(−) CR.In another patient who achieved a clinical CR pre-transplant (UPN 23), a residual CLL population was detected by flow cytometry and PCR analyses.
All 14 patients autografted achieved CR according to the NCI/WG criteria and no patient died as a result of the procedure.
At the first evaluation after transplant, nine of the 14 patients (64%) had no detectable MRD, while MRD was present in the remaining five.
With a median follow-up of 26.5 months (range, 12–52), four of the five MRD( ) patients relapsed at 9, 15, 17 and 18 months after transplant, respectively.
In contrast, only two patients of the nine MRD(−) patients have relapsed at 15 and 38 months (P = 0.02), and four became MRD( ) at 6, 12, 30, and 42 months after transplantation, respectively.
This, coupled with the advanced age of many patients as well as the relatively indolent course of the disease in a substantial proportion of cases, makes symptom palliation a reasonable treatment goal in many cases.