Abstract:
:Allogeneic hematopoietic stem-cell transplantation (HSCT) remains an effective strategy for inducing durable remission in chronic myeloid leukemia (CML). Reduced-intensity conditioning (RIC) regimens extend HSCT to older patients and those with comorbidities who would otherwise not be suitable candidates for HSCT. The long-term efficacy of this approach is not established. We evaluated outcomes of 64 CML patients with advanced-phase disease (80% beyond first chronic phase), not eligible for myeloablative preparative regimens due to older age or comorbid conditions, who were treated with fludarabine-based RIC regimens. Donor type was matched related (n =30), 1 antigen-mismatched related (n =4), or matched unrelated (n =30). With median follow-up of 7 years, overall survival (OS) and progression-free survival (PFS) were 33% and 20%, respectively, at 5 years. Incidence of treatment-related mortality (TRM) was 33%, 39%, and 48% at 100 days, and 2 and 5 years after HSCT, respectively. In multivariate analysis, only disease stage at time of HSCT was significantly predictive for both OS and PFS. RIC HSCT provides adequate disease control in chronic-phase CML patients, but alternative treatment strategies need to be explored in patients with advanced disease. TRM rates are acceptable in this high-risk population but increase over time.
journal_name
Bloodjournal_title
Bloodauthors
Kebriaei P,Detry MA,Giralt S,Carrasco-Yalan A,Anagnostopoulos A,Couriel D,Khouri IF,Anderlini P,Hosing C,Alousi A,Champlin RE,de Lima Mdoi
10.1182/blood-2007-04-085969subject
Has Abstractpub_date
2007-11-01 00:00:00pages
3456-62issue
9eissn
0006-4971issn
1528-0020pii
blood-2007-04-085969journal_volume
110pub_type
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