Allogeneic Stem Cell Transplantation for Blast Crisis Chronic Myeloid Leukemia in the Era of Tyrosine Kinase Inhibitors: A Retrospective Study by the EBMT Chronic Malignancies Working Party

Autor: Mutlu Arat, Jenny Byrne, Ibrahim Yakoub-Agha, Sascha Dietrich, Johanna Tischer, Federica Sorà, Nicolaas Schaap, Eleni Tholouli, Francis Ayuk, Joan Hendrik Veelken, Yves Chalandon, Yener Koc, Henric Jan Blok, Johan Maertens, Per Ljungman, Maija Itälä-Remes, Jürgen Finke, Pavel Jindra, Jiri Mayer, Michael Stadler, Gérard Socié, Vanderson Rocha, Jakob Passweg, Arnon Nagler, Nicolaus Kröger, Aleksandar Radujkovic
Přispěvatelé: HUS Comprehensive Cancer Center, Clinicum, Department of Oncology
Rok vydání: 2019
Předmět:
Male
Oncology
Transplantation Conditioning
Cancer development and immune defence Radboud Institute for Molecular Life Sciences [Radboudumc 2]
Tyrosine kinase inhibitor
Tyrosine-kinase inhibitor
0302 clinical medicine
PROGNOSTIC-FACTORS
CML
Outcome
ddc:616
OUTCOMES
Hazard ratio
Chronic myeloid leukemia
Hematopoietic Stem Cell Transplantation
Myeloid leukemia
Hematology
Middle Aged
Prognosis
3. Good health
Allogeneic stem cell
surgical procedures
operative
030220 oncology & carcinogenesis
Cohort
SURVIVAL
Female
Stem cell
Life Sciences & Biomedicine
Adult
medicine.medical_specialty
Allogeneic stem cell transplantation
Blast crisis
Adolescent
medicine.drug_class
GRAFT-VERSUS-LEUKEMIA
3122 Cancers
Immunology
GUIDE
Young Adult
03 medical and health sciences
All institutes and research themes of the Radboud University Medical Center
Leukemia
Myelogenous
Chronic
BCR-ABL Positive
Internal medicine
medicine
MANAGEMENT
Humans
Protein Kinase Inhibitors
Aged
Retrospective Studies
HOST-DISEASE
Transplantation
Science & Technology
Performance status
business.industry
Retrospective cohort study
allogeneic transplantation
Settore MED/15 - MALATTIE DEL SANGUE
business
030215 immunology
transplantation
Zdroj: Biology of Blood and Marrow Transplantation, 25, 10, pp. 2008-2016
Biology of Blood and Marrow Transplantation, Vol. 25, No 10 (2019) pp. 2008-2016
Biology of Blood and Marrow Transplantation
Biology of Blood and Marrow Transplantation, 25, 2008-2016
Biology of Blood and Marrow Transplantation, 25(10), 2008-2016. ELSEVIER SCIENCE INC
ISSN: 1083-8791
DOI: 10.1016/j.bbmt.2019.06.028
Popis: The prognosis of patients with blast crisis (BC) chronic myeloid leukemia (CML) is still dismal. Allogeneic stem cell transplantation represents the only curative treatment option, but data on transplant outcomes are scarce. We therefore conducted a retrospective, registry-based study of adult patients allografted for BC CML, focusing on patients with active disease at transplant and pretransplant prognostic factors. One hundred seventy patients allografted for BC CML after tyrosine kinase inhibitor pretreatment between 2004 and 2016 were analyzed. Before transplant, 95 patients were in remission, whereas 75 patients had active BC. In multivariable analysis of the entire cohort, active BC at transplant was the strongest factor associated with decreased overall survival (hazrd ratio, 1.87; P = .010) and shorter leukemia-free survival (LFS; hazard ratio, 1.69; P = .017). For patients with BC in remission at transplant, advanced age (≥45 years), lower performance status (≤80%), longer interval from diagnosis BC to transplant (>12 months), myeloablative conditioning, and unrelated donor (UD) transplant were risk factors for inferior survival. In patients with active BC, only UD transplant was significantly associated with prolonged LFS and trended toward improved overall survival. In summary, survival of patients allografted for BC CML was strongly dependent on pretransplant remission status. In patients with remission of BC, conventional prognostic factors remained the major determinants of outcome, whereas in those with active BC at transplant, UD transplant was associated with prolonged LFS in our study. ispartof: BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION vol:25 issue:10 pages:2008-2016 ispartof: location:United States status: published
Databáze: OpenAIRE
Externí odkaz: