Allogeneic stem cell transplants in chronic myeloid leukemia.
Indisputable advances in the conventional therapy of chronic myeloid leukemia (CML), like the establishment of interferon-alfa as the standard treatment for first chronic phase patients and the introduction of imatinib-mesylate as a highly active compound in patients failing interferon-alfa treatment or with more advanced disease are challenging allogeneic stem cell transplantation (SCT) as the single treatment modality, which currently offers long-term remissions below the threshold of sensitive molecular methods for the detection of BCR-ABL transcripts. Since stable molecular remissions are thought to be a prerequisite for cure of CML, allogeneic SCT remains the only curative treatment option for younger patients (i.e. beyond the age of 55 years), who have an HLA-matched related or unrelated donor. Nowadays, suitable HLA-matched unrelated donors can be identified for 70% to 75% of caucasian patients lacking an HLA-identical sibling donor, which substantially has promoted the broader application of allogeneic SCT.
Beelen
D W
DW
Department of Bone Marrow Transplantation, University Hospital of Essen, Essen, Germany.
Schaefer
U W
UW
D000293:Adolescent; D000328:Adult; D005260:Female; D006086:Graft vs Host Disease / Q000517:prevention & control; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D033581:Stem Cell Transplantation; D015996:Survival Rate; D014184:Transplantation, Homologous