Allogeneic Stem Cell Transplantation for Blast Crisis Chronic Myeloid Leukemia in the Era of Tyrosine Kinase Inhibitors: A Retrospective Study by the EBMT Chronic Malignancies Working Party
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Allogeneic Stem Cell Transplantation for Blast Crisis Chronic Myeloid Leukemia in the Era of Tyrosine Kinase Inhibitors: A Retrospective Study by the EBMT Chronic Malignancies Working Party. / Radujkovic, Aleksandar; Dietrich, Sascha; Blok, Henric-Jan; Nagler, Arnon; Ayuk, Francis; Finke, Jürgen; Tischer, Johanna; Mayer, Jiri; Koc, Yener; Sorà, Federica; Passweg, Jakob; Byrne, Jenny L; Jindra, Pavel; Veelken, Joan Hendrik; Socié, Gerard; Maertens, Johan; Schaap, Nicolaas; Stadler, Michael; Itälä-Remes, Maija; Tholouli, Eleni; Arat, Mutlu; Rocha, Vanderson; Ljungman, Per; Yakoub-Agha, Ibrahim; Kröger, Nicolaus; Chalandon, Yves.
In: BIOL BLOOD MARROW TR, Vol. 25, No. 10, 10.2019, p. 2008-2016.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Allogeneic Stem Cell Transplantation for Blast Crisis Chronic Myeloid Leukemia in the Era of Tyrosine Kinase Inhibitors: A Retrospective Study by the EBMT Chronic Malignancies Working Party
AU - Radujkovic, Aleksandar
AU - Dietrich, Sascha
AU - Blok, Henric-Jan
AU - Nagler, Arnon
AU - Ayuk, Francis
AU - Finke, Jürgen
AU - Tischer, Johanna
AU - Mayer, Jiri
AU - Koc, Yener
AU - Sorà, Federica
AU - Passweg, Jakob
AU - Byrne, Jenny L
AU - Jindra, Pavel
AU - Veelken, Joan Hendrik
AU - Socié, Gerard
AU - Maertens, Johan
AU - Schaap, Nicolaas
AU - Stadler, Michael
AU - Itälä-Remes, Maija
AU - Tholouli, Eleni
AU - Arat, Mutlu
AU - Rocha, Vanderson
AU - Ljungman, Per
AU - Yakoub-Agha, Ibrahim
AU - Kröger, Nicolaus
AU - Chalandon, Yves
N1 - Copyright © 2019 American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc. All rights reserved.
PY - 2019/10
Y1 - 2019/10
N2 - The prognosis of patients with blast crisis (BC) chronic myeloid leukemia (CML) is still dismal. Allogeneic stem cell transplantation represents the only curative treatment option, but data on transplant outcomes are scarce. We therefore conducted a retrospective, registry-based study of adult patients allografted for BC CML, focusing on patients with active disease at transplant and pretransplant prognostic factors. One hundred seventy patients allografted for BC CML after tyrosine kinase inhibitor pretreatment between 2004 and 2016 were analyzed. Before transplant, 95 patients were in remission, whereas 75 patients had active BC. In multivariable analysis of the entire cohort, active BC at transplant was the strongest factor associated with decreased overall survival (hazrd ratio, 1.87; P = .010) and shorter leukemia-free survival (LFS; hazard ratio, 1.69; P = .017). For patients with BC in remission at transplant, advanced age (≥45 years), lower performance status (≤80%), longer interval from diagnosis BC to transplant (>12 months), myeloablative conditioning, and unrelated donor (UD) transplant were risk factors for inferior survival. In patients with active BC, only UD transplant was significantly associated with prolonged LFS and trended toward improved overall survival. In summary, survival of patients allografted for BC CML was strongly dependent on pretransplant remission status. In patients with remission of BC, conventional prognostic factors remained the major determinants of outcome, whereas in those with active BC at transplant, UD transplant was associated with prolonged LFS in our study.
AB - The prognosis of patients with blast crisis (BC) chronic myeloid leukemia (CML) is still dismal. Allogeneic stem cell transplantation represents the only curative treatment option, but data on transplant outcomes are scarce. We therefore conducted a retrospective, registry-based study of adult patients allografted for BC CML, focusing on patients with active disease at transplant and pretransplant prognostic factors. One hundred seventy patients allografted for BC CML after tyrosine kinase inhibitor pretreatment between 2004 and 2016 were analyzed. Before transplant, 95 patients were in remission, whereas 75 patients had active BC. In multivariable analysis of the entire cohort, active BC at transplant was the strongest factor associated with decreased overall survival (hazrd ratio, 1.87; P = .010) and shorter leukemia-free survival (LFS; hazard ratio, 1.69; P = .017). For patients with BC in remission at transplant, advanced age (≥45 years), lower performance status (≤80%), longer interval from diagnosis BC to transplant (>12 months), myeloablative conditioning, and unrelated donor (UD) transplant were risk factors for inferior survival. In patients with active BC, only UD transplant was significantly associated with prolonged LFS and trended toward improved overall survival. In summary, survival of patients allografted for BC CML was strongly dependent on pretransplant remission status. In patients with remission of BC, conventional prognostic factors remained the major determinants of outcome, whereas in those with active BC at transplant, UD transplant was associated with prolonged LFS in our study.
U2 - 10.1016/j.bbmt.2019.06.028
DO - 10.1016/j.bbmt.2019.06.028
M3 - SCORING: Journal article
C2 - 31271884
VL - 25
SP - 2008
EP - 2016
JO - BIOL BLOOD MARROW TR
JF - BIOL BLOOD MARROW TR
SN - 1083-8791
IS - 10
ER -
