Impact of prior imatinib mesylate on the outcome of hematopoietic cell transplantation for chronic myeloid leukemia.
Imatinib mesylate (IM, Gleevec) has largely supplanted allogeneic hematopoietic cell transplantation (HCT) as first line therapy for chronic myeloid leukemia (CML). Nevertheless, many people with CML eventually undergo HCT, raising the question of whether prior IM therapy impacts HCT success. Data from the Center for International Blood and Marrow Transplant Research on 409 subjects treated with IM before HCT (IM(+)) and 900 subjects who did not receive IM before HCT (IM(-)) were analyzed. Among patients in first chronic phase, IM therapy before HCT was associated with better survival but no statistically significant differences in treatment-related mortality, relapse, and leukemia-free survival. Better HLA-matched donors, use of bone marrow, and transplantation within one year of diagnosis were also associated with better survival. A matched-pairs analysis was performed and confirmed a higher survival rate among first chronic phase patients receiving IM. Among patients transplanted with advanced CML, use of IM before HCT was not associated with treatment-related mortality, relapse, leukemia-free survival, or survival. Acute graft-versus-host disease rates were similar between IM(+) and IM(-) groups regardless of leukemia phase. These results should be reassuring to patients receiving IM before HCT.
Lee
Stephanie J
SJ
Fred Hutchinson Cancer Research Center, Seattle, WA, USA. sjlee@fhcrc.org
Kukreja
Manisha
M
Wang
Tao
T
Giralt
Sergio A
SA
Szer
Jeffrey
J
Arora
Mukta
M
Woolfrey
Ann E
AE
Cervantes
Francisco
F
Champlin
Richard E
RE
Gale
Robert Peter
RP
Halter
Joerg
J
Keating
Armand
A
Marks
David I
DI
McCarthy
Philip L
PL
Olavarria
Eduardo
E
Stadtmauer
Edward A
EA
Abecasis
Manuel
M
Gupta
Vikas
V
Khoury
H Jean
HJ
George
Biju
B
Hale
Gregory A
GA
Liesveld
Jane L
JL
Rizzieri
David A
DA
Antin
Joseph H
JH
Bolwell
Brian J
BJ
Carabasi
Matthew H
MH
Copelan
Edward
E
Ilhan
Osman
O
Litzow
Mark R
MR
Schouten
Harold C
HC
Zander
Axel R
AR
Horowitz
Mary M
MM
Maziarz
Richard T
RT
D000293:Adolescent; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001549:Benzamides; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D006680:HLA Antigens / Q000378:metabolism; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D000068877:Imatinib Mesylate; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000627:therapeutic use*; D011743:Pyrimidines / Q000627:therapeutic use*; D012042:Registries; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D001549:Benzamides; D006680:HLA Antigens; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate