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The post‐transplant cytogenetic response to interferon is a major determinant of survival after autologous stem cell transplantation for chronic myeloid leukaemia in chronic phase
Author(s) -
Olavarria Eduardo,
Reiffers Josy,
Boque Concha,
Sureda Ana,
Meloni Giovanna,
Michallet Mauricette,
Clark Richard E.,
Blaise Didier,
Carella Angelo M.,
Cahn JeanYves,
Jouet Jean P.,
Rizzoli Vittorio,
Van Biezen Anja,
Gratwohl Alois,
Goldman John M.,
Niederwieser Dietger,
Apperley Jane F.
Publication year - 2002
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1046/j.1365-2141.2002.03600.x
Subject(s) - medicine , transplantation , gastroenterology , refractory (planetary science) , stem cell , autologous stem cell transplantation , cytogenetics , immunology , oncology , biology , genetics , astrobiology , biochemistry , gene , chromosome
Summary. We have analysed the outcome of 581 autologous stem cell transplants (SCT) for chronic myeloid leukaemia (CML) in first chronic phase reported to the European Group for Blood and Marrow Transplantation between 1983 and 1998. Out off 207 patients evaluable for cytogenetics within 6 months of SCT, 36 patients (17%) were in complete cytogenetic remission (CCR), 34 (16%) in major remission (MCR), 74 (36%) in minor remission (mCR) and 63 (31%) had no cytogenetic response (NR). Interferon (IFN) was given post SCT to 267 patients. Results of the cytogenetic analysis within 1–2 years from SCT were available for 117 patients, the majority of whom ( n = 101) received IFN post SCT: 17 (15%) were in CCR, 18 (15%) in MCR, 24 (20%) in mCR and 58 (50%) NR. The median survival in this series was 96 months (71–125) from SCT. There was no difference in survival according to cytogenetic status pre‐ and immediately post SCT. However, patients in CCR or MCR at 1–2 years post SCT had a 10‐year survival of 66% compared with 36% for patients in mCR or NR ( P = 0·003). The 5‐year survival for patients receiving IFN post SCT was 72% compared with 61% for patients not treated with IFN ( P = 0·01). Out of 155 patients refractory to IFN pre SCT, 70% achieved a cytogenetic response post SCT, which was complete or major in 31%. IFN refractory patients who sustained a CCR or MCR for 1–2 years after SCT had an excellent outcome.