Allogeneic Stem Cell Transplantation for Blast Crisis Chronic Myeloid Leukemia in the Era of Tyrosine Kinase Inhibitors: A Retrospective Study by the EBMT Chronic Malignancies Working Party
Language English Country United States Media print-electronic
Document type Journal Article
PubMed
31271884
DOI
10.1016/j.bbmt.2019.06.028
PII: S1083-8791(19)30412-4
Knihovny.cz E-resources
- Keywords
- Allogeneic stem cell transplantation, Blast crisis, Chronic myeloid leukemia, Outcome, Tyrosine kinase inhibitor,
- MeSH
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive drug therapy therapy MeSH
- Adult MeSH
- Protein Kinase Inhibitors pharmacology therapeutic use MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Transplantation Conditioning methods MeSH
- Prognosis MeSH
- Retrospective Studies MeSH
- Aged MeSH
- Hematopoietic Stem Cell Transplantation methods MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Names of Substances
- Protein Kinase Inhibitors MeSH
The prognosis of patients with blast crisis (BC) chronic myeloid leukemia (CML) is still dismal. Allogeneic stem cell transplantation represents the only curative treatment option, but data on transplant outcomes are scarce. We therefore conducted a retrospective, registry-based study of adult patients allografted for BC CML, focusing on patients with active disease at transplant and pretransplant prognostic factors. One hundred seventy patients allografted for BC CML after tyrosine kinase inhibitor pretreatment between 2004 and 2016 were analyzed. Before transplant, 95 patients were in remission, whereas 75 patients had active BC. In multivariable analysis of the entire cohort, active BC at transplant was the strongest factor associated with decreased overall survival (hazrd ratio, 1.87; P = .010) and shorter leukemia-free survival (LFS; hazard ratio, 1.69; P = .017). For patients with BC in remission at transplant, advanced age (≥45 years), lower performance status (≤80%), longer interval from diagnosis BC to transplant (>12 months), myeloablative conditioning, and unrelated donor (UD) transplant were risk factors for inferior survival. In patients with active BC, only UD transplant was significantly associated with prolonged LFS and trended toward improved overall survival. In summary, survival of patients allografted for BC CML was strongly dependent on pretransplant remission status. In patients with remission of BC, conventional prognostic factors remained the major determinants of outcome, whereas in those with active BC at transplant, UD transplant was associated with prolonged LFS in our study.
Chaim Sheba Medical Center Tel Hashomer Israel
Charles University Hospital Pilsen Czech Republic
CHU de Lille LIRIC INSERM U995 Universite de Lille Lille France
Depariment of Internal Medicine 3 University Hospital of Munich Grosshadern LMU Munich Germany
Department of Internal Medicine V; University of Heidelberg Heidelberg Germany
EBMT Data Office Leiden Leiden The Netherlands
Florence Nightingale Sisli Hospital Istanbul Turkey
Hannover Medical School Hannover Germany
Hospital Sirio Libanes Sao Paulo Brazil
HUCH Comprehensive Cancer Center Helsinki Finland
Karolinska University Hospital and Karolinska Institutet Stockholm Sweden
Leiden University Hospital Leiden The Netherlands
Manchester Royal Infirmary Manchester United Kingdom
Masaryk University Hospital Brno Brno Czech Republic
Medical Park Hospitals Antalya Turkey
Nottingham University Hospital Nottingham United Kingdom
Radboud University Medical Centre Nijmegen The Netherlands
Universita Cattolica S Cuore Rome Italy
University Hospital Basel Switzerland
University Hospital Eppendorf Hamburg Germany
References provided by Crossref.org
