Outcomes and toxicity of allogeneic hematopoietic cell transplantation in chronic myeloid leukemia patients previously treated with second-generation tyrosine kinase inhibitors: a prospective non-interventional study from the Chronic Malignancy Working Party of the EBMT.

Autor: Masouridi-Levrat S; Hematology Division and Faculty of Medicine, University Hospitals of Geneva, University of Geneva, Geneva, Switzerland. stavroula.masouridi@hcuge.ch., Olavarria E; Hammersmith Hospital, London, UK., Iacobelli S; University of Rome 'Tor Vergata', Rome, Italy., Aljurf M; King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia., Morozova E; First Pavlov State Medical University of St. Petersburg, St. Petersburg, Russia., Niittyvuopio R; HUCH Comprehensive Cancer Center, Helsinki, Finland., Sengeloev H; Bone Marrow Transplant Unit L 4043, Copenhagen, Denmark., Reményi P; Dél-pesti Centrumkórház, Budapest, Hungary., Helbig G; Silesian Medical Academy, Katowice, Poland., Browne P; Hope Directorate, Dublin, Ireland., Ganser A; Hannover Medical School, Hannover, Germany., Nagler A; Chaim Sheba Medical Center, Tel-Hashomer, Israel., Snowden JA; Sheffield Teaching Hospitals NHS Trust, Sheffield, UK., Robin M; Hopital St. Louis, Paris, France., Passweg J; University Hospital, Basel, Switzerland., Van Gorkom G; Department of Internal Medicine, Division of Hematology, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands., Wallet HL; Hôpital Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France., Hoek J; EBMT Data Office Leiden, Leiden, The Netherlands., Blok HJ; EBMT Data Office Leiden, Leiden, The Netherlands., De Witte T; Nijmegen Medical Centre, Radboud University, Nijmegen, Netherlands., Kroeger N; Department of Stem Cell Transplantation, University Hospital Hamburg-Eppendorf, Hamburg, Germany., Hayden P; St. James's Hospital, Dublin, Ireland., Chalandon Y; Hematology Division and Faculty of Medicine, University Hospitals of Geneva, University of Geneva, Geneva, Switzerland., Agha IY; CHU de Lille, Univ Lille, INSERM U1286, Infinite, 59000, Lille, France.
Jazyk: angličtina
Zdroj: Bone marrow transplantation [Bone Marrow Transplant] 2022 Jan; Vol. 57 (1), pp. 23-30. Date of Electronic Publication: 2021 Oct 01.
DOI: 10.1038/s41409-021-01472-x
Abstrakt: Allogeneic hematopoietic cell transplantation (allo-HCT) remains a treatment option for patients with chronic myeloid leukemia (CML) who fail to respond to tyrosine kinase inhibitors (TKIs). While imatinib seems to have no adverse impact on outcomes after transplant, little is known on the effects of prior use of second-generation TKI (2GTKI). We present the results of a prospective non-interventional study performed by the EBMT on 383 consecutive CML patients previously treated with dasatinib or nilotinib undergoing allo-HCT from 2009 to 2013. The median age was 45 years (18-68). Disease status at transplant was CP1 in 139 patients (38%), AP or >CP1 in 163 (45%), and BC in 59 (16%). The choice of 2GTKI was: 40% dasatinib, 17% nilotinib, and 43% a sequential treatment of dasatinib and nilotinib with or without bosutinib/ponatinib. With a median follow-up of 37 months (1-77), 8% of patients developed either primary or secondary graft failure, 34% acute and 60% chronic GvHD. There were no differences in post-transplant complications between the three different 2GTKI subgroups. Non-relapse mortality was 18% and 24% at 12 months and at 5 years, respectively. Relapse incidence was 36%, overall survival 56% and relapse-free survival 40% at 5 years. No differences in post-transplant outcomes were found between the three different 2GTKI subgroups. This prospective study demonstrates the feasibility of allo-HCT in patients previously treated with 2GTKI with a post-transplant complications rate comparable to that of TKI-naive or imatinib-treated patients.
(© 2021. The Author(s).)
Databáze: MEDLINE
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