Reduced intensity conditioning is superior to nonmyeloablative conditioning for older chronic myelogenous leukemia patients undergoing hematopoietic cell transplant during the tyrosine kinase inhibitor era Journal Article
| Authors: | Warlick, E.; Ahn, K. W.; Pedersen, T. L.; Artz, A.; de Lima, M.; Pulsipher, M.; Akpek, G.; Aljurf, M.; Cahn, J. Y.; Cairo, M.; Chen, Y. B.; Cooper, B.; Deol, A.; Giralt, S.; Gupta, V.; Khoury, H. J.; Kohrt, H.; Lazarus, H. M.; Lewis, I.; Olsson, R.; Pidala, J.; Savani, B. N.; Seftel, M.; Socié, G.; Tallman, M.; Ustun, C.; Vij, R.; Vindeløv, L.; Weisdorf, D. |
| Article Title: | Reduced intensity conditioning is superior to nonmyeloablative conditioning for older chronic myelogenous leukemia patients undergoing hematopoietic cell transplant during the tyrosine kinase inhibitor era |
| Abstract: | Tyrosine kinase inhibitors (TKIs) and reduced intensity conditioning (RIC)/non-myeloablative (NMA) conditioning hematopoietic cell transplants (HCTs) have changed the therapeutic strategy for chronic myelogenous leukemia (CML) patients. We analyzed post-HCT outcomes of 306 CML patients reported to the Center for International Blood and Marrow Transplant Research aged 40 years and older undergoing RIC/NMAHCT from 2001 to 2007: 117 (38%) aged 40 to 49 years, 119 (39%) 50 to 59 years, and 70 (23%) 60 years or older. The majority (74%) had treatment with imatinib before HCT. At HCT, most patients aged 40 to 49 years were in chronic phase (CP) 1 (74%), compared with 31% aged 60 years or older. Siblings were donors for 56% aged 40 to 49 years; older cohorts had more unrelated donors. The majority received peripheral blood grafts and RIC across all age groups. 3 year overall survival (54%, 52%, and 41%), day +100 grade II-IV acute GVHD (26%, 32%, and 32%), chronic GVHD (58%, 51%, and 43%), and 1-year treatment-related mortality (18%, 20%, and 13%) were similar across ages. The 3-year relapse incidence (36%, 43%, and 66%) and disease-free survival (35%, 32%, and 16%) were inferior in the oldest cohort. Importantly, for CP1 patients, relapse and disease-free survival were similar across age cohorts. Allogeneic RIC HCT for older patients with CML can control relapse with acceptable toxicity and survival in TKI-exposed CML, especially if still in CP1. © 2012 by The American Society of Hematology. |
| Journal Title: | Blood |
| Volume: | 119 |
| Issue: | 17 |
| ISSN: | 0006-4971 |
| Publisher: | American Society of Hematology |
| Date Published: | 2012-04-26 |
| Start Page: | 4083 |
| End Page: | 4090 |
| Language: | English |
| DOI: | 10.1182/blood-2012-02-409763 |
| PROVIDER: | scopus |
| PMCID: | PMC3350369 |
| PUBMED: | 22408257 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 4 June 2012" - "CODEN: BLOOA" - "Source: Scopus" |
Altmetric
Citation Impact
BMJ Impact Analytics
Related MSK Work