Elevated incidence of chronic myeloid leukaemia in immunosuppressed solid organ transplant recipients

Comprehensive review of post–organ transplant hematologic cancers

“…148 For chronic myeloid leukemia, imatinib, nilotinib, and dasatinib are used. 149 Oberender et al found 5 cases of retransplantation of a solid organ in a review of 34 patients who developed chronic myeloid leukemia posttransplantation. 148 In acute promyelocytic leukemia, 7/11 were able to achieve complete remission, with 3 deaths.…”

“…148 For chronic myeloid leukemia, where complete remission is hard to achieve, one study showed 2 deaths among 5 patients. 149 Oberender et al found 5 cases of retransplantation of a solid organ in a review of 34 patients who developed chronic myeloid leukemia posttransplantation. 147…”

Clinical Lessons to Be Learned from Patients Developing Chronic Myeloid Leukemia While on Immunosuppressive Therapy after Solid Organ Transplantation: Yet Another Case after Orthotopic Heart Transplantation

“…Since the first description by Battin et al (1976) altogether 34 patients developing CML after SOT were reported, primarily as case reports, and 15 of these cases were published within the past 5 years, indicating a growing interest in this phenomenon [ 4 – 27 ]. In a most recent report the frequency of CML developing in SOT patients was calculated relating the total transplant numbers in a single centre and the number of CML cases observed in this group of patients to the age- and gender-matched US population [ 26 ]. Despite the low denominator of 3089 individuals in this study an age adjusted incidence rate of 34.7 per 100 000 was observed that significantly ( P < 0.0001) exceeds the US incidence of 1.6 per 100 000 [ 26 ].…”

“…In a most recent report the frequency of CML developing in SOT patients was calculated relating the total transplant numbers in a single centre and the number of CML cases observed in this group of patients to the age- and gender-matched US population [ 26 ]. Despite the low denominator of 3089 individuals in this study an age adjusted incidence rate of 34.7 per 100 000 was observed that significantly ( P < 0.0001) exceeds the US incidence of 1.6 per 100 000 [ 26 ]. Thus, under the assumption that SOT carries an elevated risk of CML, these numbers will eventually increase in the future as both the total number of transplants and the age of organ recipients are increasing.…”

“…In line with this hypothesis we previously compared by rt-PCR the BCR-ABL1 status in patients following SOT but without CML and indeed detected 5% low-level PCR positivity in these patients as compared to none in a control group without immunosuppression [ 21 ]. Finally, in a recently published article the risk to develop CML in patients after SOT was calculated to be more than 20-fold higher as in the normal population [ 26 ].…”