Citations 2
Myeloablative vs reduced-intensity conditioning allogeneic hematopoietic cell transplantation for chronic myeloid leukemia
Chhabra, Saurabh , Ahn, Kwang Woo , Hu, Zhen‐Huan , Jain, Sandeep , Černý, Jan , Copelan, Edward A. , Daly, Andrew , DeFilipp, Zachariah , Gadalla, Shahinaz M. , Ganguly, Siddhartha , Hamilton, Betty K. , Hildebrandt, Gerhard , Hsu, Jack W., Inamoto, Yoshihiro , Kanate, Abraham S. , Khoury, H. Jean, Litzow, Mark R. , Nathan, Sunita , Olsson, Richard F. , Pawarode, Attaphol , Ringdén, Olle , Rowe, Jacob M. , Saad, Ayman , Schouten, Harry C. , Seo, Sachiko , Shah, Nirav N. , Solh, Melhem , Üstün, Celalettin , Woolfrey, Ann E. , Alyea, Edwin P. , Kalaycio, Matt, Sobecks, Ronald , Saber, Wael , Cerny, Jan , Gadalla, Shahinaz M , Nathan, Sunita , Saad, Ayman , Olsson, Richard F , Ringden, Olov , Chhabra, Saurabh , Assal, Amer , Gale, Robert Peter , Lazarus, Hillard M. , Savani, Bipin N. , Stuart, Robert K. , Yared, Jean A. , Popat, Uday R
Blood Advances | November 5, 2018 | Volume: 2 | Issue: 21 | Pages: 2922-2936
10.1182/bloodadvances.2018024844
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.
Impact of prior imatinib mesylate on the outcome of hematopoietic cell transplantation for chronic myeloid leukemia
Lee, Stephanie J. , Kukreja, Manisha, Szer, Jeff , Arora, Mukta , Woolfrey, Ann E. , Cervantes, Francisco , Halter, Joerg , Marks, David I. , Olavarría, Eduardo, Stadtmauer, Edward A. , Abecasis, Manuel, Gupta, Vikas , Khoury, H. Jean, Hale, Gregory A., Rizzieri, David A. , Antin, Joseph H. , Bolwell, Brian J., Carabasi, Matthew, Copelan, Edward A. , İlhan, Osman , Litzow, Mark R. , Schouten, H, Zander, Axel R., Horowitz, Mary M. , Halter, Jörg , Wang, Tao , Giralt, Sergio , Champlin, Richard E. , Gale, Robert Peter , Keating, Armand , McCarthy, Philip L. , George, Biju , Liesveld, Jane L. , Maziarz, Richard Thomas , Gupta, Vikas , Lee, Stephanie J
Blood | July 30, 2008 | Volume: 112 | Issue: 8 | Pages: 3500-3507
AbstractImatinib mesylate (IM, Gleevec) has largely supplanted allogeneic hematopoietic cell transplantation (HCT) as first line therapy for chronic myeloid leukemia (CML). Nevertheless, many people with CML eventually undergo HCT, raising the question of whether prior IM therapy impacts HCT success. Data from the Center for International Blood and Marrow Transplant Research on 409 subjects treated with IM before HCT (IM+) and 900 subjects who did not receive IM before HCT (IM−) were analyzed. Among patients in first chronic phase, IM therapy before HCT was associated with better survival but no statistically significant differences in treatment-related mortality, relapse, and leukemia-free survival. Better HLA-matched donors, use of bone marrow, and transplantation within one year of diagnosis were also associated with better survival. A matched-pairs analysis was performed and confirmed a higher survival rate among first chronic phase patients receiving IM. Among patients transplanted with advanced CML, use of IM before HCT was not associated with treatment-related mortality, relapse, leukemia-free survival, or survival. Acute graft-versus-host disease rates were similar between IM+ and IM− groups regardless of leukemia phase. These results should be reassuring to patients receiving IM before HCT.