Cytogenetic response to prior treatment with interferon-α is predictive for survival after allogeneic hematopoietic stem cell transplantation in chronic myeloid leukemia

Maywald, Ole; Pfirrmann, Markus; Berger, Ursula; Breitscheidel, Lusine; Gratwohl, Aloïs; Kolb, Hans‐Jochem; Beelen, Dietrich W.; Tobler, Andreas; Metzgeroth, Georgia; Gnad, S. U.; Hochhaus, Andreas; Hasford, Joerg; Hehlmann, Rüdiger; Reiter, Andreas

doi:10.1038/sj.leu.2404100

Cited by 8 publications

(3 citation statements)

References 22 publications

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“…12 In our current cohort, 36 of 52 patients who underwent transplantation in first CP showed at least some cytogenetic response before transplantation. In support of this interpretation are the significantly better survival probability after allo SCT for patients with reduced tumor load under IFN (5-year survival: 63.6% vs 49.2%), 13 a positive impact of prior imatinib on the outcome of allo SCT in CP CML, 4 and the observation in adult Ph-positive acute lymphoblastic leukemia that the extent of minimal residual disease under imatinib determines outcome after allo SCT. 22,23 The results of an overall survival higher than 90% at 2 years are also remarkable in view of the fact that the majority of CP patients underwent transplantation with an EBMT score equal to or higher than 3.…”

Section: Discussionsupporting

confidence: 49%

“…There are hints that pretransplantation imatinib might improve outcome 4 in line with earlier observations that reduction of leukemia load by IFN before transplantation is associated with better transplantation outcome. 13 We made use of an interim safety analysis of the randomized German CML Study IV, designed to optimize imatinib-based therapy, 14 to determine the role of allo SCT in the imatinib era within the context of a prospective controlled multicenter trial and according to predefined criteria. We show that survival rates in chronic phase (CP) CML 3 years after transplantation are not different from those achieved with drug treatment alone, but with high rates of molecular response.…”

Section: Introductionmentioning

confidence: 99%

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Allogeneic hematopoietic stem cell transplantation (allo SCT) for chronic myeloid leukemia in the imatinib era: evaluation of its impact within a subgroup of the randomized German CML Study IV

Saußele¹,

Lauseker

Gratwohl

et al. 2010

Blood

193

121

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The role of allogeneic stem cell transplantation in chronic myeloid leukemia is being reevaluated. Whereas drug treatment has been shown to be superior in firstline treatment, data on allogeneic hematopoietic stem cell transplantation (allo SCT) as second-line therapy after imatinib failure are scarce. Using an interim safety analysis of the randomized German CML Study IV designed to optimize imatinib therapy by combination, dose escalation, and transplantation, we here report on 84 patients who underwent consecutive transplantation according to predefined criteria (low European Group for Blood and Marrow Transplantation [EBMT] score, imatinib failure, and advanced disease). Three-year survival after transplantation of 56 patients in chronic phase was 91% (median follow-up: 30 months). Transplantation-related mortality was 8%. In a matched pair comparison of patients who received a transplant and those who did not, survival was not different. Threeyear survival after transplantation of 28 patients in advanced phase was 59%. Eighty-eight percent of patients who received a transplant achieved complete molecular remissions. We conclude that allo SCT could become the preferred second-line option after imatinib failure for suitable patients with a donor. The study is registered at the National Institutes of Health, http://clinicaltrials.gov: NCT00055874.

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Section: Discussionsupporting

confidence: 49%

Section: Introductionmentioning

confidence: 99%

Allogeneic hematopoietic stem cell transplantation (allo SCT) for chronic myeloid leukemia in the imatinib era: evaluation of its impact within a subgroup of the randomized German CML Study IV

Saußele¹,

Lauseker

Gratwohl

et al. 2010

Blood

193

121

View full text Add to dashboard Cite

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“…Based on our findings, we recommend BM harvest teams attempt to collect a higher number of nucleated cells for infusion in CML patients undergoing BMT from a VUD. Cytogenetic response to previous treatment with IFN-a [19] and imatinib [20] has been reported to be predictive for survival after allogeneic SCT in Ph1 CML. In the multivariate model of our entire cohort, MCyR at the time of BMT was an independent predictive factor for transplantation outcome.…”

Section: Discussionmentioning

confidence: 99%

Outcome of 125 Children with Chronic Myelogenous Leukemia Who Received Transplants from Unrelated Donors: The Japan Marrow Donor Program

Muramatsu

Kojima

Yoshimi

et al. 2010

Biology of Blood and Marrow Transplantation

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Because of a small number of patients, only a few studies have addressed the outcome of bone marrow transplantation (BMT) in children with Philadelphia chromosome-positive (Ph+) chronic myelogenous leukemia (CML), who receive graft from a volunteer-unrelated donor (VUD), especially after practical application of imatinib mesylate. The outcomes of BMT from a VUD in 125 children with Ph+ CML were retrospectively reviewed. Patients were identified through the Japan Marrow Donor Program as having undergone BMT between 1993 and 2005 and were aged 1-19 years at the time of transplant (median age, 14 years). The probabilities of 5-year overall survival (OS) and leukemia-free survival (LFS) were 59.3% and 55.5%, respectively. Multivariate analysis identified the following unfavorable survival factors: infused total nucleated cell dose<314 x 10(6) /kg (relative risk [RR]=2.43; 95% confidence interval [CI]=1.33-4.44; P=.004), advanced phase (RR=2.43; 95% CI=1.37-4.31; P=.004), and no major cytogenetic response (MCyR) at the time of BMT (RR=6.55; 95% CI=1.98-21.6; P=.002). Of the 17 patients treated with imatinib, 15 (88%) achieved MCyR at the time of BMT, and this group had an excellent 5-year OS of 81.9%. Disease phase, infused total nucleated cell dose, and cytogenetic response were independent risk factors for survival of unrelated BMT. These findings provide important information for assessing the indications for and improving outcome in unrelated BMT for the treatment of pediatric CML.

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Current Awareness in Hematological Oncology

2006

Hematological Oncology

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In order to keep subscribers up‐to‐date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of hematological oncology. Each bibliography is divided into 14 sections: 1 Books, Reviews & Symposia; 2 General; Leukemias: 3 Lymphoblastic; 4 Myeloid & Myelodysplastic Syndromes; 5 Chronic; 6 Others; Lymphomas: 7 Hodgkin's; 8 Non‐Hodgkin's; 9 Plasmacytomas/Multiple Myelomas; 10 Others; 11 Bone Marrow Transplantation; 12 Cytokines; 13 Diagnosis; 14 Cytogenetics. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted.

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Cytogenetic response to prior treatment with interferon-α is predictive for survival after allogeneic hematopoietic stem cell transplantation in chronic myeloid leukemia

Cited by 8 publications

References 22 publications

Allogeneic hematopoietic stem cell transplantation (allo SCT) for chronic myeloid leukemia in the imatinib era: evaluation of its impact within a subgroup of the randomized German CML Study IV

Allogeneic hematopoietic stem cell transplantation (allo SCT) for chronic myeloid leukemia in the imatinib era: evaluation of its impact within a subgroup of the randomized German CML Study IV

Outcome of 125 Children with Chronic Myelogenous Leukemia Who Received Transplants from Unrelated Donors: The Japan Marrow Donor Program

Current Awareness in Hematological Oncology

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