Imatinib combined with myeloablative allogeneic hematopoietic stem cell transplantation for advanced phases of chronic myeloid leukemia

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• 作者：Yi Luo ; Yanmin Zhao ; Yamin Tan ; Jimin Shi ; Xiaoyan Han ; Yanlong Zheng ; Li Li ; Jingsong He ; Wanzhuo Xie ; Xiujin Ye ; Zhen Cai ; Maofang Lin ; He Huang ; ^{hehuang@medmail.com.cn}
• 关键词：Chronic myeloid leukemia ; Advanced phase ; Myeloablative allogeneic stem cell transplantation ; Imatinib ; Response
• 刊名：Leukemia Research
• 出版年：2011
• 出版时间：October, 2011
• 年：2011
• 卷：35
• 期：10
• 页码：1307-1311
• 全文大小：1K

文摘

To evaluat the efficacy and safety of myeloablative allogeneic hematopoietic stem cell transplantation (allo-HSCT) combined with imatinib for advanced chronic myeloid leukemia (CML), 15 patients with accelerated phase (n = 6) or blast crisis (n = 9) were enrolled in this study. All the patients were conditioned with cyclophosphamide and busulfan, and treated with cyclosporin (CsA)/methotrexate (MTX)/mycophenolate mofetil (MMF) for graft-versus-host disease (GVHD) prophylaxis. Eleven of these 15 patients (73.3 % ) achieved complete hematologic response to pre-transplant imatinib, and six (40 % ) achieved a cytogenetic response. No engraftment failure was observed and the early transplant-related mortality was only 6.7 % . Grade 3/4 acute GVHD occurred in 13.3 % of patients. Chronic GVHD was observed in 61.5 % , including 23.1 % suffered from extensive disease. The 5-year estimated rates of relapse, transplant-related mortality and overall survival were 21.0 ¡À 10.8 % 13.7 ¡À 10.8 % and 66.0 ¡À 12.4 % , respectively. Ten (66.7 % ) of 15 patients are alive with complete molecular remission, even after a median follow-up of 25 months after withdrawal of imatinib. In conclusion, even CML in advanced phases may have a satisfactory outcome after myeloablative allo-HSCT combined with imatinib, which may provide good remission prior to transplantation and reduce relapse risk, with low toxicity.