Challenges for allogeneic hematopoietic stem cell transplantation in chronic myeloid leukemia in the era of tyrosine kinase inhibitors.
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Challenges for allogeneic hematopoietic stem cell transplantation in chronic myeloid leukemia in the era of tyrosine kinase inhibitors. / Oyekunle, Anthony; Klyuchnikov, Evgeny; Ocheni, Sunday; Kröger, Nicolaus; Zander, Axel R.; Baccarani, Michele; Bacher, Ulrike.
in: ACTA HAEMATOL-BASEL, Jahrgang 126, Nr. 1, 1, 2011, S. 30-39.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Challenges for allogeneic hematopoietic stem cell transplantation in chronic myeloid leukemia in the era of tyrosine kinase inhibitors.
AU - Oyekunle, Anthony
AU - Klyuchnikov, Evgeny
AU - Ocheni, Sunday
AU - Kröger, Nicolaus
AU - Zander, Axel R.
AU - Baccarani, Michele
AU - Bacher, Ulrike
PY - 2011
Y1 - 2011
N2 - Following the introduction of the tyrosine kinase inhibitor (TKI) imatinib in the treatment of chronic myeloid leukemia (CML) patients, the allogeneic hematopoietic stem cell transplantation (HSCT) scene in CML has changed dramatically. The number of patients receiving HSCT in first chronic phase (CP) has declined rapidly, as allogeneic HSCT in CP is now performed in these patients only in case of failure or intolerance of TKIs. Second, those CML patients who undergo allogeneic HSCT represent a selection of high-risk patients due to more advanced disease with high rates of accelerated or blast phase (being associated with an increased relapse risk), advanced age and relevant co-morbidities. Efforts at meeting these special challenges are being developed: treatment with TKIs aims to improve the pre-transplant remission status before HSCT. Dose-reduced conditioning protocols were introduced to decrease transplant-related mortality in patients with co-morbidities or older age. In the post-transplant period, TKIs may be administered for prophylaxis and for treatment of post-transplant relapse. Still, the outcome of patients in advanced CML phases remains guarded, and requires an improvement in current transplant strategies.
AB - Following the introduction of the tyrosine kinase inhibitor (TKI) imatinib in the treatment of chronic myeloid leukemia (CML) patients, the allogeneic hematopoietic stem cell transplantation (HSCT) scene in CML has changed dramatically. The number of patients receiving HSCT in first chronic phase (CP) has declined rapidly, as allogeneic HSCT in CP is now performed in these patients only in case of failure or intolerance of TKIs. Second, those CML patients who undergo allogeneic HSCT represent a selection of high-risk patients due to more advanced disease with high rates of accelerated or blast phase (being associated with an increased relapse risk), advanced age and relevant co-morbidities. Efforts at meeting these special challenges are being developed: treatment with TKIs aims to improve the pre-transplant remission status before HSCT. Dose-reduced conditioning protocols were introduced to decrease transplant-related mortality in patients with co-morbidities or older age. In the post-transplant period, TKIs may be administered for prophylaxis and for treatment of post-transplant relapse. Still, the outcome of patients in advanced CML phases remains guarded, and requires an improvement in current transplant strategies.
KW - Adult
KW - Humans
KW - Aged
KW - Middle Aged
KW - Adolescent
KW - Child
KW - Child, Preschool
KW - Infant
KW - Transplantation, Homologous
KW - Antineoplastic Agents/therapeutic use
KW - Stem Cell Transplantation
KW - Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy/surgery
KW - Protein Kinase Inhibitors/therapeutic use
KW - Adult
KW - Humans
KW - Aged
KW - Middle Aged
KW - Adolescent
KW - Child
KW - Child, Preschool
KW - Infant
KW - Transplantation, Homologous
KW - Antineoplastic Agents/therapeutic use
KW - Stem Cell Transplantation
KW - Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy/surgery
KW - Protein Kinase Inhibitors/therapeutic use
M3 - SCORING: Journal article
VL - 126
SP - 30
EP - 39
JO - ACTA HAEMATOL-BASEL
JF - ACTA HAEMATOL-BASEL
SN - 0001-5792
IS - 1
M1 - 1
ER -
