Back to Search
Start Over
The Role of Molecular or Cytogenetic Response as a Favorable Prognostic Factor Before Hematopoietic Stem Cell Transplantation for Chronic Myeloid Leukemia.
- Source :
-
Transplantation and cellular therapy [Transplant Cell Ther] 2024 Jun; Vol. 30 (6), pp. 597.e1-597.e8. Date of Electronic Publication: 2024 Mar 23. - Publication Year :
- 2024
-
Abstract
- Tyrosine kinase inhibitors (TKIs) have revolutionized therapy for patients with chronic myeloid leukemia (CML) over the last two decades. However, some patients still do not achieve an adequate response to these drugs, and hematopoietic stem cell transplantation (HSCT) is indicated in this scenario. We present the results of a 20-year follow-up study of 70 patients who underwent transplantation after TKI failure. The primary objective of this study was to evaluate overall survival (OS) and the secondary objective was to evaluate the outcomes of relapse-free survival (RFS), GVHD-free, relapse-free survival (GFRS) and the incidences of relapse (RI), non-relapse mortality (NRM), acute and chronic GVHD. Median survival was 11 years, with a 1-year OS of 70% (57.8 to 79.3) and a 5-year OS of 57.7% (45.1 to 68.5). The estimated 5-year OS was not different for CP1 (60%) versus advanced stages (45%); P = .60. The degree of response immediately before transplantation was directly associated with worse outcomes [HR 5.89 (1.19-29.16); P = .03] for patients with only a hematological response compared with patients with a cytogenetic or molecular response. This study corroborates the potential of HSCT in the scenario of therapeutic failure and highlights the role of molecular or cytogenetic response as a potential target to be achieved before transplantation.<br /> (Copyright © 2024 The American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Humans
Male
Female
Adult
Middle Aged
Prognosis
Protein Kinase Inhibitors therapeutic use
Young Adult
Follow-Up Studies
Aged
Adolescent
Graft vs Host Disease
Treatment Outcome
Disease-Free Survival
Hematopoietic Stem Cell Transplantation
Leukemia, Myelogenous, Chronic, BCR-ABL Positive mortality
Leukemia, Myelogenous, Chronic, BCR-ABL Positive therapy
Subjects
Details
- Language :
- English
- ISSN :
- 2666-6367
- Volume :
- 30
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Transplantation and cellular therapy
- Publication Type :
- Academic Journal
- Accession number :
- 38522578
- Full Text :
- https://doi.org/10.1016/j.jtct.2024.03.020