TY - JOUR
T1 - The evolution of treatment strategies for patients with chronic myeloid leukemia relapsing after allogeneic bone marrow transplant
T2 - Can tyrosine kinase inhibitors replace donor lymphocyte infusions?
AU - Zeidner, Joshua F.
AU - Zahurak, Marianna
AU - Rosner, Gary L.
AU - Gocke, Christopher D.
AU - Jones, Richard J.
AU - Smith, B. Douglas
N1 - Publisher Copyright:
© 2014 Informa UK, Ltd.
PY - 2015/1/1
Y1 - 2015/1/1
N2 - 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.
AB - 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.
KW - Allogeneic transplant
KW - Chronic myeloid leukemia
KW - Relapse
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U2 - 10.3109/10428194.2014.910868
DO - 10.3109/10428194.2014.910868
M3 - Article
C2 - 24712979
AN - SCOPUS:84922346751
SN - 1042-8194
VL - 56
SP - 128
EP - 134
JO - Leukemia and Lymphoma
JF - Leukemia and Lymphoma
IS - 1
ER -