<p><b>OBJECTIVE</b>To investigate the
effectiveness and
safety of reduced intensity conditioning allogeneic
hematopoietic stem cell transplantation (RIC allo-HSCT) in ultra high
risk chronic lymphocytic leukemia (CLL)
patients with the deletion of p53 to deepen the
understanding of allo-HSCT in the
treatment of CLL.</p><p><b>
METHODS</b>In this
retrospective study, a total of 4 ultra high
risk CLL
patients with the deletion of p53 in our center between July 2012 and Jan 2014 were enrolled. The RIC regimen was administered and the hematopoietic reconstitution,
transplantation related
mortality (TRM), overall
survival (OS), progress free
survival (PFS) were evaluated.</p><p><b>RESULTS</b>We registered 4
patients with the median age of 56 years (49-61 years), including 3
males and 1
female. The median mononuclear
cells (MNC) and CD34(+)
cells were 6.54 (2.85-14.7) × 10(8)/kg (recipient
body weight) and 5.81 (2.85-7.79) × 10(6)/kg (recipient
body weight), respectively. The median
time of the
neutrophil recovery was 11 days (range of 9-12 days), and the median
time of the
platelet recovery 5.5 days (range of 0-11 days). Three
patients (75%) attained a full
donor chimerism at day 28 after
transplantation and one (25%) got a mixed
chimerism of
donor and recipient. During the follow-up at a median
time of 26.5 months (range of 21-39 months), 2 (50%)
patients developed acute
graft versus host disease (aGVHD) grade I and 2 (50%)
patients got CMV
infection. One
patient got
herpes zoster virus and EB
virus infections. No
transplantation related
mortality was found in the 4
patients. One
patient who was in partial response status progressed 5 months after
transplantation, and the other 3
patients remained in durable remission after allo-HSCT.</p><p><b>CONCLUSION</b>These results suggested that RIC allo-HSCT showed durable remission, good tolerance and acceptable
toxicity, which could be a better option for the
treatment of ultra high
risk CLL
patients with the deletion of p53 and was worth to be investigated and applied widely in
future.</p>