title: Prognostic factors for outcomes in allogeneic transplantation for CML in the imatinib era: a CIBMTR analysis.
abstract: Allogeneic hematopoietic SCT is an effective treatment in accelerated (AP) or blast phase (BP) CML. Imatinib (IM) has transient but significant activity in advanced phases of CML, which may permit early allografting for responding patients. To identify prognostic factors in allograft recipients previously treated with IM, we analyzed 449 allogeneic hematopoietic SCTs performed from 1999 to 2004 in advanced-phase CML, using the data reported to the Center for International Blood and Marrow Transplant Research. CML patients in second chronic phase (CP2, n=184), AP (n=185) and BP (n=80) received HLA-identical sibling (27%), related (3%), or matched or mismatched unrelated donor (70%), peripheral blood (47%) or BM (53%) hematopoietic SCT after myeloablative (78%) or non-myeloablative (22%) conditioning. In all, 52% in CP2, 49% in AP and 46% in BP received IM before hematopoietic SCT. Disease-free survival was 35-40% for CP2, 26-27% for AP and 8-11% for BP. Cumulative incidence of acute and chronic GVHD and TRM were not affected by the stages of CML or pre-hematopoietic SCT IM exposure. Multivariate analyses showed that conventional prognostic indicators remain the strongest determinants of transplant outcomes. In conclusion, there are no new prognostic indicators of the outcomes of allogeneic hematopoietic SCT for advanced-phase CML in the IM era.
authors: Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA 30322, USA. hkhoury@emory.edu
authors: H J
authors: HJ
authors: Khoury
authors: M
authors: M
authors: Kukreja
authors: J M
authors: JM
authors: Goldman
authors: T
authors: T
authors: Wang
authors: J
authors: J
authors: Halter
authors: M
authors: M
authors: Arora
authors: V
authors: V
authors: Gupta
authors: D A
authors: DA
authors: Rizzieri
authors: B
authors: B
authors: George
authors: A
authors: A
authors: Keating
authors: R P
authors: RP
authors: Gale
authors: D I
authors: DI
authors: Marks
authors: P L
authors: PL
authors: McCarthy
authors: A
authors: A
authors: Woolfrey
authors: J
authors: J
authors: Szer
authors: S A
authors: SA
authors: Giralt
authors: R T
authors: RT
authors: Maziarz
authors: J
authors: J
authors: Cortes
authors: M M
authors: MM
authors: Horowitz
authors: S J
authors: SJ
authors: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001549:Benzamides; D002648:Child; D018572:Disease-Free Survival; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D000068877:Imatinib Mesylate; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000008:administration & dosage*; D047428:Protein Kinase Inhibitors / Q000008:administration & dosage*; D011743:Pyrimidines / Q000008:administration & dosage*; D012189:Retrospective Studies; D035781:Siblings; D015996:Survival Rate; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous
chemical_list: D001549:Benzamides; D010879:Piperazines; D047428:Protein Kinase Inhibitors; D011743:Pyrimidines; D000068877:Imatinib Mesylate