Outcome of allogeneic SCT in patients with chronic myeloid leukemia in the era of tyrosine kinase inhibitor therapy.
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Outcome of allogeneic SCT in patients with chronic myeloid leukemia in the era of tyrosine kinase inhibitor therapy. / Oyekunle, Anthony; Zander, Axel R; Binder, Mascha; Ayuketang, Francis Ayuk; Zabelina, Tatiana; Christopeit, Maximilian; Stübig, Thomas; Alchalby, Haefaa; Schafhausen, Philippe; Lellek, Heinrich; Wolschke, Christine; Müller, Ingo; Bacher, Ulrike; Kröger, Nicolaus-Martin.
In: ANN HEMATOL, Vol. 92, No. 4, 4, 2013, p. 487-496.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Outcome of allogeneic SCT in patients with chronic myeloid leukemia in the era of tyrosine kinase inhibitor therapy.
AU - Oyekunle, Anthony
AU - Zander, Axel R
AU - Binder, Mascha
AU - Ayuketang, Francis Ayuk
AU - Zabelina, Tatiana
AU - Christopeit, Maximilian
AU - Stübig, Thomas
AU - Alchalby, Haefaa
AU - Schafhausen, Philippe
AU - Lellek, Heinrich
AU - Wolschke, Christine
AU - Müller, Ingo
AU - Bacher, Ulrike
AU - Kröger, Nicolaus-Martin
PY - 2013
Y1 - 2013
N2 - The introduction of tyrosine kinase inhibitors (TKIs) for chronic myeloid leukemia (CML) led to a dramatic change in the role of allogeneic stem cell transplantation (SCT) with a rapid decline in the number of patients receiving SCT in first chronic phase (CP1). We evaluated 68 consecutive patients in all phases of CML (male/female = 39:29, 27 in CP1), who received SCT from related/unrelated donors (related/unrelated = 23:45) under myeloablative or reduced intensity conditioning (MAC/RIC = 45:23). Forty-eight patients (71 %) received TKIs pre-SCT, 20 patients post-SCT (29 %). Overall survival (OS) of CP1 patients achieved a plateau of 85 % at 10 months. Relapse-free survival (RFS) of CP1 patients was 85 % at 1 and 2 years, and 81 % at 5 years. Multivariate analysis showed adverse OS and RFS for patients transplanted >CP1 (hazard ratio (HR) = 6.61 and 4.62) and those who had grade III-IV aGvHD (HR = 2.45 and 1.82). Patients with advanced CML had estimated OS of 65 and 47 %; and RFS of 41 and 32 % at 1 and 2 years respectively. Therefore, for patients with advanced CML phases, allogeneic SCT provides an acceptable chance of cure. Transplant research should focus on improving conditioning regimens and post-SCT management for this subgroup of CML patients.
AB - The introduction of tyrosine kinase inhibitors (TKIs) for chronic myeloid leukemia (CML) led to a dramatic change in the role of allogeneic stem cell transplantation (SCT) with a rapid decline in the number of patients receiving SCT in first chronic phase (CP1). We evaluated 68 consecutive patients in all phases of CML (male/female = 39:29, 27 in CP1), who received SCT from related/unrelated donors (related/unrelated = 23:45) under myeloablative or reduced intensity conditioning (MAC/RIC = 45:23). Forty-eight patients (71 %) received TKIs pre-SCT, 20 patients post-SCT (29 %). Overall survival (OS) of CP1 patients achieved a plateau of 85 % at 10 months. Relapse-free survival (RFS) of CP1 patients was 85 % at 1 and 2 years, and 81 % at 5 years. Multivariate analysis showed adverse OS and RFS for patients transplanted >CP1 (hazard ratio (HR) = 6.61 and 4.62) and those who had grade III-IV aGvHD (HR = 2.45 and 1.82). Patients with advanced CML had estimated OS of 65 and 47 %; and RFS of 41 and 32 % at 1 and 2 years respectively. Therefore, for patients with advanced CML phases, allogeneic SCT provides an acceptable chance of cure. Transplant research should focus on improving conditioning regimens and post-SCT management for this subgroup of CML patients.
KW - Adult
KW - Humans
KW - Male
KW - Aged
KW - Female
KW - Middle Aged
KW - Adolescent
KW - Young Adult
KW - Treatment Outcome
KW - Cohort Studies
KW - Child
KW - Prognosis
KW - Retrospective Studies
KW - Transplantation, Homologous
KW - Antineoplastic Combined Chemotherapy Protocols/therapeutic use
KW - Protein Kinase Inhibitors/therapeutic use
KW - Protein-Tyrosine Kinases/antagonists & inhibitors
KW - Hematopoietic Stem Cell Transplantation/methods
KW - Leukemia, Myelogenous, Chronic, BCR-ABL Positive/diagnosis/drug therapy/mortality/therapy
KW - Adult
KW - Humans
KW - Male
KW - Aged
KW - Female
KW - Middle Aged
KW - Adolescent
KW - Young Adult
KW - Treatment Outcome
KW - Cohort Studies
KW - Child
KW - Prognosis
KW - Retrospective Studies
KW - Transplantation, Homologous
KW - Antineoplastic Combined Chemotherapy Protocols/therapeutic use
KW - Protein Kinase Inhibitors/therapeutic use
KW - Protein-Tyrosine Kinases/antagonists & inhibitors
KW - Hematopoietic Stem Cell Transplantation/methods
KW - Leukemia, Myelogenous, Chronic, BCR-ABL Positive/diagnosis/drug therapy/mortality/therapy
U2 - 10.1007/s00277-012-1650-8
DO - 10.1007/s00277-012-1650-8
M3 - SCORING: Journal article
C2 - 23250623
VL - 92
SP - 487
EP - 496
JO - ANN HEMATOL
JF - ANN HEMATOL
SN - 0939-5555
IS - 4
M1 - 4
ER -
