title: Improved outcome in patients with chronic myelogenous leukemia after allogeneic hematopoietic stem cell transplantation over the past 25 years: a single-center experience.
abstract: Although imatinib has become standard first-line therapy in chronic myelogenous leukemia (CML), allogeneic hematopoietic stem cell transplantation (HSCT) is still considered to be an important treatment alternative for patients with drug resistance or advanced disease. We retrospectively analyzed 175 adult CML patients who underwent HSCT at our institution between 1983 and 2007, with the aim to compare outcomes in patient subgroups and to identify prognostic variables. The median follow-up was 65 months. The probability of overall survival (OS) for all patients was 62%, with a significant improvement seen in the imatinib-era (2001-2007) compared to previous time periods (P <.05). Furthermore, a significantly better outcome for patients with chronic phase CML compared to patients with accelerated or blast phase could be observed (P < .05). Cumulative incidence (CI) of treatment-related mortality (TRM) was 9.7% at 100 days and 1 year after HSCT. CI of relapse was 5% at 1 year and 7.5% at 3 years after HSCT. Post-HSCT outcome was not influenced by pretreatment therapy with imatinib, donor type, or a conditioning regimen with total body irradiation (TBI). These data confirm earlier observations and suggest that allogeneic HSCT is still an important treatment option for high-risk patients with CML, and should thus remain an integral component in current and future treatment algorithms.
authors.affiliation: Department of Internal Medicine I, Bone Marrow Transplantation Unit, Medical University of Vienna, Austria.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Boehm
authors.forename: Barbara
authors.initials: B
authors.lastname: Walcherberger
authors.forename: Wolfgang R
authors.initials: WR
authors.lastname: Sperr
authors.forename: Stefan
authors.initials: S
authors.lastname: Wöhrer
authors.forename: Karin
authors.initials: K
authors.lastname: Dieckmann
authors.forename: Agathe
authors.initials: A
authors.lastname: Rosenmayr
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Pernicka
authors.forename: Gottfried
authors.initials: G
authors.lastname: Fischer
authors.forename: Nina
authors.initials: N
authors.lastname: Worel
authors.forename: Gerlinde
authors.initials: G
authors.lastname: Mitterbauer
authors.forename: Ilse
authors.initials: I
authors.lastname: Schwarzinger
authors.forename: M
authors.initials: M
authors.lastname: Mitterbauer
authors.forename: Oskar A
authors.initials: OA
authors.lastname: Haas
authors.forename: Klaus
authors.initials: K
authors.lastname: Lechner
authors.forename: W
authors.initials: W
authors.lastname: Hinterberger
authors.forename: Peter
authors.initials: P
authors.lastname: Valent
authors.forename: Hildegard T
authors.initials: HT
authors.lastname: Greinix
authors.forename: Werner
authors.initials: W
authors.lastname: Rabitsch
authors.forename: Peter
authors.initials: P
authors.lastname: Kalhs
mesh_terms: D000328:Adult; D001549:Benzamides; D005260:Female; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods* / Q000401:mortality / Q000639:trends*; D006801:Humans; D000068877:Imatinib Mesylate; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000627:therapeutic use; D011379:Prognosis; D011743:Pyrimidines / Q000627:therapeutic use; D012008:Recurrence; D012189:Retrospective Studies; D015996:Survival Rate; D019172:Transplantation Conditioning / Q000379:methods; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate