Prognostic factors for outcomes in allogeneic transplantation for CML in the imatinib era: a CIBMTR analysis.

Journal Article

Allogeneic hematopoietic SCT is an effective treatment in accelerated (AP) or blast phase (BP) CML. Imatinib (IM) has transient but significant activity in advanced phases of CML, which may permit early allografting for responding patients. To identify prognostic factors in allograft recipients previously treated with IM, we analyzed 449 allogeneic hematopoietic SCTs performed from 1999 to 2004 in advanced-phase CML, using the data reported to the Center for International Blood and Marrow Transplant Research. CML patients in second chronic phase (CP2, n=184), AP (n=185) and BP (n=80) received HLA-identical sibling (27%), related (3%), or matched or mismatched unrelated donor (70%), peripheral blood (47%) or BM (53%) hematopoietic SCT after myeloablative (78%) or non-myeloablative (22%) conditioning. In all, 52% in CP2, 49% in AP and 46% in BP received IM before hematopoietic SCT. Disease-free survival was 35-40% for CP2, 26-27% for AP and 8-11% for BP. Cumulative incidence of acute and chronic GVHD and TRM were not affected by the stages of CML or pre-hematopoietic SCT IM exposure. Multivariate analyses showed that conventional prognostic indicators remain the strongest determinants of transplant outcomes. In conclusion, there are no new prognostic indicators of the outcomes of allogeneic hematopoietic SCT for advanced-phase CML in the IM era.

Full Text

Duke Authors

Cited Authors

  • Khoury, HJ; Kukreja, M; Goldman, JM; Wang, T; Halter, J; Arora, M; Gupta, V; Rizzieri, DA; George, B; Keating, A; Gale, RP; Marks, DI; McCarthy, PL; Woolfrey, A; Szer, J; Giralt, SA; Maziarz, RT; Cortes, J; Horowitz, MM; Lee, SJ

Published Date

  • June 2012

Published In

Volume / Issue

  • 47 / 6

Start / End Page

  • 810 - 816

PubMed ID

  • 21986636

Electronic International Standard Serial Number (EISSN)

  • 1476-5365

Digital Object Identifier (DOI)

  • 10.1038/bmt.2011.194

Language

  • eng

Conference Location

  • England