The role of hematopoietic stem cell transplantation in Chronic Lymphocytic Leukemia

Chronic Lymphocytic Leukemia is a common and often incurable lymphoproliferative disorder. Purine nucleoside analogues, and more recently monoclonal antibodies, have increased the potential for obtaining complete or even molecular remissions. Despite these advances, disease recurrence and relapse remain the major concern. Hematopoietic stem cell transplantation is now regularly being considered in this patient population. Attempts at autologous transplantation have not shown additional benefit in advanced refractory disease. However, recent reports show that allogeneic transplantation may represent a chance for cure. This benefit must be balanced with the risk of transplant related mortality and graft-versus-host-disease. Current studies suggest that the use of non-myeloablative transplantation may provide durable disease control without the toxicity of conventional transplants. This review will focus on the role of hematopoietic stem cell transplantation in CLL.