慢性淋巴细胞白血病同种异体造血干细胞移植后先发性免疫干预清除残留病 (RICAC)

Inclusion Criteria:

• Patients with CLL (Matutes score 4 or 5) stages A, B, C with evolution criteria according IWCLL 2008 or lymphocytic lymphoma with severity criteria (EBMT criteria) which indicated allograft (deletion 17p) and requiring treatment

• Age: 18-70 years

• At least one of the following criteria of poor prognosis (EBMT recommendations - Dreger 2007)

  1. No response or relapse within 12 months of treatment with purine analogues (including "fludarabine refractory" i.e patients in response <PR and / or relapse within 6 months after at least 2 courses of Fludurabine)
  2. relapse within 24 months after combination therapy including purine analogs or autograft, with indication of new start of treatment
  3. Mutation/deletion 17p13 (p53) with indication for treatment

• Partial response (PR) or complete response (CR) at the last treatment (IWCLL 2008)

• Residual mass <5 cm (clinical and CT scan)

• Identical intrafamilial donor HLA (or with a mismatch) or in the absence of family donor, an unrelated donor 10/10 for HLA A, B, C, DR, DQ and is committed to giving DLI (see consent form donor)

• Sorror score comorbidity: ≤ 2

• Written informed consent

• Member or beneficiary of a social security system

Exclusion Criteria:

• Richter Syndrome
• Usual contraindications for realisation of allogeneic transplantation including
• Uncontrolled bacterial, viral or fungal infection
• Pregnancy or lactating women
• Cardiac contraindication : Cardiac ejection fraction <50%
• Pulmonary contraindication : DLCO <50%
• Renal contraindication : Creatininine clearance <30 ml / min
• Hepatic contraindication : AST and / or ALT and / or total bilirubine> 2 N except Gilbert disease or localisation specific LLC
• HIV positivity
• Cancer evolution or de novo occurred in the previous 5 years except basal cell cancer skin or carcinoma in situ of the cervix of uterus
• Affection psychiatric disease