The role of stem cell transplantation for chronic myelogenous leukemia in the 21st century

Barrett, A. John; Ito, Sawa

doi:10.1182/blood-2014-10-567784

Cited by 48 publications

(41 citation statements)

References 90 publications

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“…Furthermore, dasatinib and nilotinib showed higher efficacy than that of imatinib in treatment of patients with newly diagnosed CML‐CP . Therefore, allo‐HSCT is now considered for patients with disease progression or for patients after treatment failure with multiple TKIs …”

Section: Introductionmentioning

confidence: 99%

Clinical impact of pretransplant use of multiple tyrosine kinase inhibitors on the outcome of allogeneic hematopoietic stem cell transplantation for chronic myelogenous leukemia

et al. 2017

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Tyrosine kinase inhibitors (TKIs) are widely used to treat patients with chronic myelogenous leukemia in the chronic phase (CML-CP), and outcomes of TKI treatment for patients with CML-CP have been excellent. Since multiple TKIs are currently available, second-line or third-line TKI therapy is considered for patients who are intolerant of or resistant to the previous TKI treatment. Therefore, allogeneic hematopoietic stem cell transplantation (allo-HSCT) is considered only for patients with disease progression or for patients after treatment failure with multiple TKIs. To reflect the current clinical situation of patients with CML-CP, we tried to clarify whether prior TKI treatment affects the outcome of allo-HSCT. Data from 237 patients for whom the number of pretransplant TKIs varied from one to three were used for analysis. Before allo-HSCT, 153 patients were treated with one TKI, 49 patients were treated with two TKIs and 35 patients were treated with three TKIs. In addition to conventional risk factors, i.e., disease status at transplantation and patient's age, the use of three TKIs before transplantation was identified as a significant adverse factor for prognosis. Nonrelapse mortality rate was higher in patients treated with three TKIs than in patients treated with one or two TKIs. Our results suggest that allo-HSCT could be considered for young patients with CML-CP who manifest resistance to second-line TKI therapy and who have an appropriate donor.

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Section: Introductionmentioning

confidence: 99%

Clinical impact of pretransplant use of multiple tyrosine kinase inhibitors on the outcome of allogeneic hematopoietic stem cell transplantation for chronic myelogenous leukemia

et al. 2017

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“…[1][2][3][4][5] With the improvement of conditioning chemotherapy and supportive care, the outcome of this strategy has improved. 6 Yet a major issue remains, which is the quest for a fully-matched donor.…”

mentioning

confidence: 99%

Longer delay of hematological recovery and increased transfusion needs after haploidentical compared to non-haploidentical stem cell transplantation

Desjonqueres

Illiaquer²,

Duquesne

et al. 2016

Bone Marrow Transplant

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“…Current recommendations suggest consideration of allogenic stem cell transplant (AlloSCT) consultation with donor search at first TKI failure for patients who are at high risk and fit to receive transplant 14. Indications for allogeneic HSCT in chronic phase include high risk with first failure of imatinib, first failure of second generation TKI, failure of 2+ TKIs and T315L mutation 14…”

Section: Discussionmentioning

confidence: 99%

“…Since CML occurs mostly in older patients, with median age at diagnosis being 64 years,1 RIC regimen is frequently used for AlloSCT . However, it has a higher rate of relapse compared to myeloablative recipients 14. The trade-off between taking the risk of progressing into blastic phase with dismal chances for recovery or early HSCT with the risk of immediate mortality can be a difficult reality for both the patient and the guiding physician 13…”

Section: Discussionmentioning

confidence: 99%

Case of relentless chronic phase of chronic myeloid leukaemia

et al. 2016

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Initial treatment of chronic phase chronic myeloid leukaemia is straightforward in today's era of tyrosine kinase inhibitors. However, managing refractory cases remain a major challenge due to the multiple factors that can influence decision-making, including medication tolerance, disease burden, mutation status, comorbidities, availability of donor, and fitness for an ablative conditioning. We report a male patient presenting with chronic phase chronic myeloid leukaemia who was treated with 5 different tyrosine kinase inhibitors either due to intolerance and/or failed response. He subsequently received 2 haploidentical haematopoietic stem cells transplants before achieving complete remission. This case highlights various treatment options, need for vigilant disease monitoring, and the possibility of complete positive response even after many lines of therapy failure.

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The role of stem cell transplantation for chronic myelogenous leukemia in the 21st century

Cited by 48 publications

References 90 publications

Clinical impact of pretransplant use of multiple tyrosine kinase inhibitors on the outcome of allogeneic hematopoietic stem cell transplantation for chronic myelogenous leukemia

Clinical impact of pretransplant use of multiple tyrosine kinase inhibitors on the outcome of allogeneic hematopoietic stem cell transplantation for chronic myelogenous leukemia

Longer delay of hematological recovery and increased transfusion needs after haploidentical compared to non-haploidentical stem cell transplantation

Case of relentless chronic phase of chronic myeloid leukaemia

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