Characterisation of extramedullary relapse in patients with chronic myeloid leukemia in advanced disease after allogeneic stem cell transplantation.
Standard
Characterisation of extramedullary relapse in patients with chronic myeloid leukemia in advanced disease after allogeneic stem cell transplantation. / Ocheni, Sunday; Iwanski, Gabriela; Schafhausen, Philippe; Zander, Axel R.; Ayuketang Ayuk, Francis; Klyuchnikov, Evgeny; Zabelina, Tatjana; Fiedler, Walter; Schnittger, Susanne; Hochhaus, Andreas; Brümmendorf, Tim; Kröger, Nicolaus; Bacher, Ulrike.
in: LEUKEMIA LYMPHOMA, Jahrgang 50, Nr. 4, 4, 2009, S. 551-558.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Characterisation of extramedullary relapse in patients with chronic myeloid leukemia in advanced disease after allogeneic stem cell transplantation.
AU - Ocheni, Sunday
AU - Iwanski, Gabriela
AU - Schafhausen, Philippe
AU - Zander, Axel R.
AU - Ayuketang Ayuk, Francis
AU - Klyuchnikov, Evgeny
AU - Zabelina, Tatjana
AU - Fiedler, Walter
AU - Schnittger, Susanne
AU - Hochhaus, Andreas
AU - Brümmendorf, Tim
AU - Kröger, Nicolaus
AU - Bacher, Ulrike
PY - 2009
Y1 - 2009
N2 - Recently, higher extramedullary relapse rates following allogeneic stem cell transplantation (SCT) in myeloid malignancies were reported e.g. because of selection of poor-risk patients. We analysed five consecutive patients with post-transplant extramedullary relapse of chronic myeloid leukemia (CML) out of a total of 24 patients (21%) undergoing allo-SCT. All five patients with extramedullary relapse had clonal evolution and a history of blast phase (BP). In particular, 56% of the patients in BP had extramedullary relapse with no extramedullary relapse in patients with chronic/accelerated phase. Most frequent manifestation sites were the skeletal system, the muscles/subcutaneous tissue and the central nervous system. In one case chloroma was mimicking myositis of the lower limbs. Combined approaches were performed including irradiation (n = 4), chemotherapy (n = 2), IM (n = 2), dasatinib (n = 4), nilotinib (n = 1), a novel aurora-kinase-inhibitor (n = 1), donor lymphocytes (n = 2) or a second allo-SCT (n = 2). Transient response was achieved in one case, stable partial remissions in two cases, whereas two cases were refractory. Research should focus on prospective studies aiming to improve treatment of extramedullary relapse in stem cell recipients with CML with a special focus on the role of second generation tyrosine kinase inhibitors.
AB - Recently, higher extramedullary relapse rates following allogeneic stem cell transplantation (SCT) in myeloid malignancies were reported e.g. because of selection of poor-risk patients. We analysed five consecutive patients with post-transplant extramedullary relapse of chronic myeloid leukemia (CML) out of a total of 24 patients (21%) undergoing allo-SCT. All five patients with extramedullary relapse had clonal evolution and a history of blast phase (BP). In particular, 56% of the patients in BP had extramedullary relapse with no extramedullary relapse in patients with chronic/accelerated phase. Most frequent manifestation sites were the skeletal system, the muscles/subcutaneous tissue and the central nervous system. In one case chloroma was mimicking myositis of the lower limbs. Combined approaches were performed including irradiation (n = 4), chemotherapy (n = 2), IM (n = 2), dasatinib (n = 4), nilotinib (n = 1), a novel aurora-kinase-inhibitor (n = 1), donor lymphocytes (n = 2) or a second allo-SCT (n = 2). Transient response was achieved in one case, stable partial remissions in two cases, whereas two cases were refractory. Research should focus on prospective studies aiming to improve treatment of extramedullary relapse in stem cell recipients with CML with a special focus on the role of second generation tyrosine kinase inhibitors.
M3 - SCORING: Zeitschriftenaufsatz
VL - 50
SP - 551
EP - 558
JO - LEUKEMIA LYMPHOMA
JF - LEUKEMIA LYMPHOMA
SN - 1042-8194
IS - 4
M1 - 4
ER -