Impact of prior imatinib mesylate on the outcome of hematopoietic cell transplantation for chronic myeloid leukemia.


Journal Article

Imatinib mesylate (IM, Gleevec) has largely supplanted allogeneic hematopoietic cell transplantation (HCT) as first line therapy for chronic myeloid leukemia (CML). Nevertheless, many people with CML eventually undergo HCT, raising the question of whether prior IM therapy impacts HCT success. Data from the Center for International Blood and Marrow Transplant Research on 409 subjects treated with IM before HCT (IM(+)) and 900 subjects who did not receive IM before HCT (IM(-)) were analyzed. Among patients in first chronic phase, IM therapy before HCT was associated with better survival but no statistically significant differences in treatment-related mortality, relapse, and leukemia-free survival. Better HLA-matched donors, use of bone marrow, and transplantation within one year of diagnosis were also associated with better survival. A matched-pairs analysis was performed and confirmed a higher survival rate among first chronic phase patients receiving IM. Among patients transplanted with advanced CML, use of IM before HCT was not associated with treatment-related mortality, relapse, leukemia-free survival, or survival. Acute graft-versus-host disease rates were similar between IM(+) and IM(-) groups regardless of leukemia phase. These results should be reassuring to patients receiving IM before HCT.

Full Text

Duke Authors

Cited Authors

  • Lee, SJ; Kukreja, M; Wang, T; Giralt, SA; Szer, J; Arora, M; Woolfrey, AE; Cervantes, F; Champlin, RE; Gale, RP; Halter, J; Keating, A; Marks, DI; McCarthy, PL; Olavarria, E; Stadtmauer, EA; Abecasis, M; Gupta, V; Khoury, HJ; George, B; Hale, GA; Liesveld, JL; Rizzieri, DA; Antin, JH; Bolwell, BJ; Carabasi, MH; Copelan, E; Ilhan, O; Litzow, MR; Schouten, HC; Zander, AR; Horowitz, MM; Maziarz, RT

Published Date

  • October 15, 2008

Published In

Volume / Issue

  • 112 / 8

Start / End Page

  • 3500 - 3507

PubMed ID

  • 18664621

Pubmed Central ID

  • 18664621

Electronic International Standard Serial Number (EISSN)

  • 1528-0020

Digital Object Identifier (DOI)

  • 10.1182/blood-2008-02-141689


  • eng

Conference Location

  • United States