title: Hematopoietic cell transplantation in chronic myeloid leukemia in the age of tyrosine kinase inhibitors.
abstract: The development and widespread use of tyrosine kinase inhibitors (TKIs) has relegated the use of hematopoietic cell transplant (HCT), in most countries, to chronic myeloid leukemia (CML) patients who fail or are intolerant to TKIs. Its long-term cost effectiveness compared to TKIs, however, has maintained its use as front-line treatment in some areas. Advances in HCT, including the development of intravenous busulfan and plasma assays permitting dose adjustment, have improved results of HCT in CML. Improved supportive care has lowered the incidence of non-relapse mortality and improved survival. The availability of reduced-intensity preparative regimens, molecular typing of unrelated donors, and the use of cord blood and haploidentical donors has expanded the application of HCT to nearly any patient with an appropriate indication. From 2006 to 2010, approximately one thousand HCTs were performed annually in patients with CML. Better understanding of recent advances will improve the appropriate use and results of HCT in patients with CML.
authors.affiliation: Levine Cancer Institute, Carolinas Healthcare System, Charlotte, NC 28204, USA.
authors.forename: Edward A
authors.initials: EA
authors.lastname: Copelan
authors.forename: Michael R
authors.initials: MR
authors.lastname: Grunwald
authors.forename: Nilanjan
authors.initials: N
authors.lastname: Ghosh
authors.forename: Dragos
authors.initials: D
authors.lastname: Plesca
authors.forename: Jigar
authors.initials: J
authors.lastname: Trivedi
authors.forename: Belinda R
authors.initials: BR
authors.lastname: Avalos
mesh_terms: D000970:Antineoplastic Agents / Q000737:chemistry; D002066:Busulfan / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003362:Cost-Benefit Analysis; D005312:Fetal Blood; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000628:therapy*; D011184:Postoperative Period; D047428:Protein Kinase Inhibitors / Q000737:chemistry*; D011505:Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors; D011505:Protein-Tyrosine Kinases; D002066:Busulfan