Unknown

Dataset Information

0

Myeloablative vs reduced-intensity conditioning allogeneic hematopoietic cell transplantation for chronic myeloid leukemia.


ABSTRACT: Allogeneic hematopoietic cell transplantation (allo-HCT) is a potentially curative treatment of chronic myeloid leukemia (CML). Optimal conditioning intensity for allo-HCT for CML in the era of tyrosine kinase inhibitors (TKIs) is unknown. Using the Center for International Blood and Marrow Transplant Research database, we sought to determine whether reduced-intensity/nonmyeloablative conditioning (RIC) allo-HCT and myeloablative conditioning (MAC) result in similar outcomes in CML patients. We evaluated 1395 CML allo-HCT recipients between the ages of 18 and 60 years. The disease status at transplant was divided into the following categories: chronic phase 1, chronic phase 2 or greater, and accelerated phase. Patients in blast phase at transplant and alternative donor transplants were excluded. The primary outcome was overall survival (OS) after allo-HCT. MAC (n = 1204) and RIC allo-HCT recipients (n = 191) from 2007 to 2014 were included. Patient, disease, and transplantation characteristics were similar, with a few exceptions. Multivariable analysis showed no significant difference in OS between MAC and RIC groups. In addition, leukemia-free survival and nonrelapse mortality did not differ significantly between the 2 groups. Compared with MAC, the RIC group had a higher risk of early relapse after allo-HCT (hazard ratio [HR], 1.85; P = .001). The cumulative incidence of chronic graft-versus-host disease (cGVHD) was lower with RIC than with MAC (HR, 0.77; P = .02). RIC provides similar survival and lower cGVHD compared with MAC and therefore may be a reasonable alternative to MAC for CML patients in the TKI era.

SUBMITTER: Chhabra S 

PROVIDER: S-EPMC6234373 | BioStudies | 2018-01-01

REPOSITORIES: biostudies

Similar Datasets

2011-01-01 | S-EPMC4130206 | BioStudies
2019-01-01 | S-EPMC6755039 | BioStudies
2019-01-01 | S-EPMC6557700 | BioStudies
2014-01-01 | S-EPMC3951192 | BioStudies
2015-01-01 | S-EPMC4568162 | BioStudies
2020-01-01 | S-EPMC7565021 | BioStudies
2019-01-01 | S-EPMC7144878 | BioStudies
2017-01-01 | S-EPMC5455603 | BioStudies
2019-01-01 | S-EPMC7232773 | BioStudies
2018-01-01 | S-EPMC6800017 | BioStudies