scholarly journals Allogeneic Hematopoietic Cell Transplantation Is a Curative Treatment Option for Advanced-Stage Chronic Myeloid Leukemia in the TKI Era, a Single Institution Retrospective Study of 29 Post AP/BC Cases

2015 ◽  
Vol 21 (2) ◽  
pp. S299-S300
Author(s):  
Hiroki Mizumaki ◽  
Shinsuke Takagi ◽  
Naoyuki Uchida ◽  
Kosei Kageyama ◽  
Daisuke Kaji ◽  
...  
2018 ◽  
Vol 2 (21) ◽  
pp. 2922-2936 ◽  
Author(s):  
Saurabh Chhabra ◽  
Kwang Woo Ahn ◽  
Zhen-Huan Hu ◽  
Sandeep Jain ◽  
Amer Assal ◽  
...  

Abstract Allogeneic hematopoietic cell transplantation (allo-HCT) is a potentially curative treatment of chronic myeloid leukemia (CML). Optimal conditioning intensity for allo-HCT for CML in the era of tyrosine kinase inhibitors (TKIs) is unknown. Using the Center for International Blood and Marrow Transplant Research database, we sought to determine whether reduced-intensity/nonmyeloablative conditioning (RIC) allo-HCT and myeloablative conditioning (MAC) result in similar outcomes in CML patients. We evaluated 1395 CML allo-HCT recipients between the ages of 18 and 60 years. The disease status at transplant was divided into the following categories: chronic phase 1, chronic phase 2 or greater, and accelerated phase. Patients in blast phase at transplant and alternative donor transplants were excluded. The primary outcome was overall survival (OS) after allo-HCT. MAC (n = 1204) and RIC allo-HCT recipients (n = 191) from 2007 to 2014 were included. Patient, disease, and transplantation characteristics were similar, with a few exceptions. Multivariable analysis showed no significant difference in OS between MAC and RIC groups. In addition, leukemia-free survival and nonrelapse mortality did not differ significantly between the 2 groups. Compared with MAC, the RIC group had a higher risk of early relapse after allo-HCT (hazard ratio [HR], 1.85; P = .001). The cumulative incidence of chronic graft-versus-host disease (cGVHD) was lower with RIC than with MAC (HR, 0.77; P = .02). RIC provides similar survival and lower cGVHD compared with MAC and therefore may be a reasonable alternative to MAC for CML patients in the TKI era.


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