Allogeneic hematopoietic stem cell transplantation for patients with chronic myeloid leukemia in second chronic phase attained by imatinib after onset of blast crisis |
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Authors: | Ying Wang Depei Wu Aining Sun Zhengming Jin Huiying Qiu Miao Miao Xiaowen Tang Zhengzheng Fu |
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Institution: | (1) Department of Hematology, First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, 188 Shizi Sreet, 215006 Suzhou, China |
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Abstract: | The prognosis for patients with chronic myeloid leukemia (CML) in blast crisis (BC) remains dismal even with the availability
of the BCR-ABL tyrosine kinase inhibitor imatinib, since it only offers short-term benefit in most cases. Allogeneic hematopoietic
stem cell transplantation (HSCT) seems to be a viable option for BC-CML patients who attained remission. We treated ten patients
with ablative allogeneic HSCT, who achieved second chronic phase (CP) by the use of imatinib after onset of BC. Median patient
age was 32 years (range 17–46). Among them, four patients received HSCT from human leukocyte antigen mismatched haplo-identical
family donors. After a median follow-up of 24 months (range 8–42), six out of the ten patients were alive in durable complete
cytogenetic remission, one patient died in relapse 4 months after transplantation, the others died of severe acute graft-versus-host
disease and associated infections. No unusual organ toxicities and engraftment difficulties were observed. Extensive chronic
GVHD developed in three of six patients who could be evaluated. Patients transplanted with haplo-identical donors had a high
treatment-related modality. Allogeneic HSCT may represent a feasible treatment for patients with CML in second CP attained
by imatinib after onset of BC especially when a suitable donor is available. |
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Keywords: | Hematopoietic stem cell transplantation Chronic myeloid leukemia Imatinib Blast crisis |
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