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Allogeneic haematopoietic cell transplantation for chronic myelogenous leukaemia in the era of imatinib: a retrospective multicentre study
Author(s) -
Bornhäuser Martin,
Kröger Nicolaus,
Schwerdtfeger Rainer,
SchaferEckart Karin,
Sayer Herbert G.,
Scheid Christoph,
Stelljes Mattias,
Kienast Joachim,
Mundhenk Peter,
Fruehauf Stefan,
Kiehl Michael G.,
Wandt Hannes,
Theuser Catrin,
Ehninger Gerhard,
Zander Axel R.
Publication year - 2006
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/j.0902-4441.2005.t01-1-ejh2321.x
Subject(s) - medicine , fludarabine , busulfan , transplantation , univariate analysis , cyclophosphamide , chronic myelogenous leukemia , total body irradiation , imatinib mesylate , imatinib , cumulative incidence , surgery , retrospective cohort study , incidence (geometry) , oncology , gastroenterology , hematopoietic stem cell transplantation , leukemia , chemotherapy , multivariate analysis , physics , myeloid leukemia , optics
Objective: To analyse the results of allogeneic haematopoietic cell transplantation (HCT) in patients with advanced stages of Philadelphia chromosome‐positive chronic myelogenous leukaemia (CML) who had previously been treated with imatinib mesylate (IM). Methods: We analysed the outcome of 61 patients with CML who had received allogeneic HCT from sibling ( n = 18) or unrelated ( n = 43) donors after having been treated with IM. Forty‐one patients had received IM because of accelerated or blast phase CML. Conditioning therapy contained standard doses of busulfan ( n = 25) or total‐body irradiation ( n = 20) in conjunction with cyclophosphamide in the majority of cases. Sixteen patients received dose‐reduced conditioning with fludarabine‐based regimens. Results: The incidence of grades II–IV and III–IV graft‐versus‐host disease was 66% and 38% respectively. The probability of overall survival (OS), disease‐free survival (DFS) and relapse at 18 months for the whole patient cohort were 37%, 33% and 24% respectively. The probability of non‐relapse mortality (NRM) at 100 d and 12 months was 30% and 46% respectively. Univariate analysis showed that fludarabine‐based conditioning therapy, age ≥40 yr and >12 months interval between diagnosis and transplantation were associated with a significantly lower OS and DFS and a higher NRM. Conclusion: These data suggest that although pretreatment with IM is not an independent negative prognostic factor, it cannot improve the dismal prognosis of CML patients at high risk for transplant‐related mortality.