title: Outcome of allotransplants in patients with chronic-phase chronic myeloid leukemia following imatinib failure: prognosis revisited.
abstract: BACKGROUND
  The outcome of allotransplants in patients with chronic -phase (CP) chronic myeloid leukemia (CML) who progressed to accelerated phase (AP) or blast phase (BP) following imatinib failure, especially those without preceding suboptimal response, remains unclear.
  
  
  METHODS
  One hundred and five patients with newly-diagnosed CML-CP were retrospectively reviewed. Sixty-six patients received first-line imatinib therapy, 26 received interferon followed by imatinib, and 13 received front-line allotransplants.
  
  
  RESULTS
  No significant differences were found in overall survival (p=0.57) and blast-free survival (p=0.25) between different first-line therapies. Among 66 imatinib-treated patients, 18 (27.3%) developed imatinib failure, 14 (21.2%) progressed to AP/BP, including eight without preceding suboptimal response. Compared to front-line allotransplant, patients with imatinib failure had a significantly worse overall survival after allotransplants (p=0.015), mainly due to an increase of treatment-related mortality.
  
  
  CONCLUSIONS
  Early recognition of imatinib-treated patients who should receive an allotransplant is important rather than waiting until imatinib failure with disease progression.
authors.affiliation: 100, Tzyou 1st Road, Kaohsiung, 807, Taiwan, ROC. shlin@kmu.edu.tw.
authors.forename: Yi-Chang
authors.initials: YC
authors.lastname: Liu
authors.forename: Hui-Hua
authors.initials: HH
authors.lastname: Hsiao
authors.forename: Chao-Sung
authors.initials: CS
authors.lastname: Chang
authors.forename: Ta-Chih
authors.initials: TC
authors.lastname: Liu
authors.forename: Wen-Chi
authors.initials: WC
authors.lastname: Yang
authors.forename: Jui-Feng
authors.initials: JF
authors.lastname: Hsu
authors.forename: Chiung-Tang
authors.initials: CT
authors.lastname: Huang
authors.forename: Shih-Feng
authors.initials: SF
authors.lastname: Cho
authors.forename: Cheng-Han
authors.initials: CH
authors.lastname: Wu
authors.forename: Yu-Fen
authors.initials: YF
authors.lastname: Tsai
authors.forename: Sheng-Fung
authors.initials: SF
authors.lastname: Lin
mesh_terms: D064591:Allografts; D000970:Antineoplastic Agents / Q000494:pharmacology* / Q000627:therapeutic use; D001549:Benzamides / Q000494:pharmacology* / Q000627:therapeutic use; D018572:Disease-Free Survival; D019008:Drug Resistance, Neoplasm; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D000068877:Imatinib Mesylate; D053208:Kaplan-Meier Estimate; D015466:Leukemia, Myeloid, Chronic-Phase / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D015999:Multivariate Analysis; D010879:Piperazines / Q000494:pharmacology* / Q000627:therapeutic use; D011379:Prognosis; D016016:Proportional Hazards Models; D011743:Pyrimidines / Q000494:pharmacology* / Q000627:therapeutic use; D012189:Retrospective Studies; D017211:Treatment Failure
chemical_list: D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate
keywords: Chronic myeloid leukemia; allotransplantation; hematopoietic stem cell transplantation; imatinib; tyrosine kinase inhibitor