title: Complete molecular responses are achieved after reduced intensity stem cell transplantation and donor lymphocyte infusion in chronic myeloid leukemia.
abstract: Patients with newly diagnosed chronic phase chronic myeloid leukemia were treated with imatinib mesylate (IM) for 6 to 12 months to establish disease control, before reduced intensity stem cell transplantation (RISCT). Escalating doses of donor lymphocyte infusions were given from 6 months after transplantation to eradicate residual disease. A total of 18 patients entered the study and 15 received RISCT (median follow-up, 31 months). RISCT was well tolerated with rapid engraftment, short inpatient stays, and few readmissions. Viral reactivation was common, although extensive graft-versus-host disease occurred infrequently. Donor lymphocyte infusions were given as part of the RISCT protocol in 13 of 15 patients. BCR-ABL transcripts continued to decrease after RISCT, and 8 (53%) patients achieved sustained undetectable levels. All patients are currently off IM. Although IM is now established as first-line therapy for chronic phase chronic myeloid leukemia, this protocol is a safe, well-tolerated, and effective strategy in these patients. This study is registered at http://www.controlled-trials.com as ISRCTN86187144.
authors: Section of Experimental Haematology and Haemopoietic Stem Cells, University of Glasgow, Glasgow, USA.
authors: Nicholas B
authors: NB
authors: Heaney
authors: Mhairi
authors: M
authors: Copland
authors: Karen
authors: K
authors: Stewart
authors: Judith
authors: J
authors: Godden
authors: Anne N
authors: AN
authors: Parker
authors: I Grant
authors: IG
authors: McQuaker
authors: Graeme M
authors: GM
authors: Smith
authors: Charles
authors: C
authors: Crawley
authors: Pat
authors: P
authors: Shepherd
authors: Tessa L
authors: TL
authors: Holyoake
mesh_terms: D000328:Adult; D001549:Benzamides; D006085:Graft Survival; D006086:Graft vs Host Disease; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D000068877:Imatinib Mesylate; D007902:Length of Stay; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000628:therapy*; D017710:Lymphocyte Transfusion / Q000379:methods*; D008875:Middle Aged; D010879:Piperazines / Q000627:therapeutic use; D011743:Pyrimidines / Q000627:therapeutic use; D016896:Treatment Outcome; D014775:Virus Activation
chemical_list: D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate