Allogeneic stem-cell transplantation provides excellent results in advanced stage chronic myeloid leukemia with major cytogenetic response to pre-transplant imatinib therapy.
To determine the impact of imatinib therapy prior to allogeneic stem-cell transplantation in advanced stage chronic myelogenous leukaemia (CML), 30 CML patients who had received imatinib as part of pre-transplant treatment were analysed, with special emphasis on the cytogenetic response to imatinib therapy shortly before transplantation. Median patient age was 51 years (range, 24 - 64). At the time of transplantation all patients were in second or higher chronic phase (CP). The median follow-up after allogeneic transplantation was 360 days (range, 24 - 1524). Cox regression analysis revealed that the quality of cytogenetic response was a prognostic factor for transplant-related mortality (p = 0.050), relapse incidence (p = 0.015), leukaemia-free survival (p = 0.002) and overall survival (p = 0.006). A cytogenetic response with <35%BCR-ABL-positive interphase nuclei in FISH analysis from bone marrow was associated with a probability of overall survival of 81% at 3 years. In conclusion, our data suggest that advanced stage CML has an excellent outcome after allogeneic haematopoietic stem-cell transplantation when transplanted in the phase of cytogenetic response to imatinib.
Weisser
Martin
M
Department of Medicine III, Klinikum Grosshadern, Ludwig Maximilians University of Munich, Germany. martin.weisser@gmx.de
Schleuning
Michael
M
Haferlach
Claudia
C
Schwerdtfeger
Rainer
R
Kolb
Hans Jochem
HJ
D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001549:Benzamides; D003131:Combined Modality Therapy; D005260:Female; D016044:Fusion Proteins, bcr-abl / Q000235:genetics*; D020544:Graft vs Leukemia Effect; D006801:Humans; D000068877:Imatinib Mesylate; D015994:Incidence; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis; D010879:Piperazines / Q000627:therapeutic use*; D011505:Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors; D011743:Pyrimidines / Q000627:therapeutic use*; D012074:Remission Induction; D033581:Stem Cell Transplantation; D015996:Survival Rate; D014184:Transplantation, Homologous; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate; D011505:Protein-Tyrosine Kinases; D016044:Fusion Proteins, bcr-abl