The evolution of treatment strategies for patients with chronic myeloid leukemia relapsing after allogeneic bone marrow transplant: Can tyrosine kinase inhibitors replace donor lymphocyte infusions?

Joshua F. Zeidner, Marianna Zahurak, Gary Rosner, Christopher Gocke, Richard J Jones, B Douglas Smith

Research output: Contribution to journalArticle

Abstract

The optimal treatment for chronic myeloid leukemia (CML) relapsing following allogeneic bone marrow transplant (alloBMT) is unknown. We performed a single-center retrospective analysis of 71 consecutive patients undergoing alloBMT for CML from 1995 to 2008. A multi-state model was used to quantify cumulative incidences of complete molecular response (CMR) and death following alloBMT. The primary analysis was comparison of three treatment interventions (tyrosine kinase inhibitor: TKI, donor lymphocyte infusion: DLI, and TKI + DLI) for relapsed disease post-alloBMT. Forty-five (63%) patients relapsed post-alloBMT (molecular relapse: n = 16, cytogenetic relapse: n = 20, hematologic relapse: n = 2, advanced phase relapse: n = 7) and 40 patients underwent one of three treatments: TKI-only (n = 13), DLI-only (n = 11) or TKI + DLI (n = 16). Although not statistically significant, the TKI-only group had the highest cumulative incidence of CMR and lowest cumulative incidence of death compared to DLI and TKI + DLI. These data support the finding that TKI therapy is active in the post-alloBMT setting.

Original languageEnglish (US)
Pages (from-to)128-134
Number of pages7
JournalLeukemia and Lymphoma
Volume56
Issue number1
DOIs
StatePublished - Jan 1 2015

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Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Protein-Tyrosine Kinases
Bone Marrow
Tissue Donors
Lymphocytes
Transplants
Recurrence
Incidence
Therapeutics
Cytogenetics

Keywords

  • Allogeneic transplant
  • Chronic myeloid leukemia
  • Relapse

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

Cite this

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title = "The evolution of treatment strategies for patients with chronic myeloid leukemia relapsing after allogeneic bone marrow transplant: Can tyrosine kinase inhibitors replace donor lymphocyte infusions?",
abstract = "The optimal treatment for chronic myeloid leukemia (CML) relapsing following allogeneic bone marrow transplant (alloBMT) is unknown. We performed a single-center retrospective analysis of 71 consecutive patients undergoing alloBMT for CML from 1995 to 2008. A multi-state model was used to quantify cumulative incidences of complete molecular response (CMR) and death following alloBMT. The primary analysis was comparison of three treatment interventions (tyrosine kinase inhibitor: TKI, donor lymphocyte infusion: DLI, and TKI + DLI) for relapsed disease post-alloBMT. Forty-five (63{\%}) patients relapsed post-alloBMT (molecular relapse: n = 16, cytogenetic relapse: n = 20, hematologic relapse: n = 2, advanced phase relapse: n = 7) and 40 patients underwent one of three treatments: TKI-only (n = 13), DLI-only (n = 11) or TKI + DLI (n = 16). Although not statistically significant, the TKI-only group had the highest cumulative incidence of CMR and lowest cumulative incidence of death compared to DLI and TKI + DLI. These data support the finding that TKI therapy is active in the post-alloBMT setting.",
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AU - Smith, B Douglas

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