2011, Number 5
<< Back Next >>
Rev Invest Clin 2011; 63 (5)
Overall survival of chronic myeloid leukemia patients treated with related donor hematopoietic stem cell transplant or imatinib
López-Hernández MA, Alvarado-Ibarra M, González-Avante CM
Language: English
References: 25
Page: 494-499
PDF size: 131.03 Kb.
ABSTRACT
Objective. To determine the overall survival (OS) of Ph
1 positive chronic myeloid leukemia (CML) patients treated with allogeneic hematopoietic stem cell transplant (AHSCT) vs. imatinib.
Material and methods. We retrospectively included CML patients treated with related donor myeolablative and non-myeloablative AHSCT, between 1992 and 2009. Another group consisted of a patient cohort treated with imatinib between 2001 and 2009. The main variable was the persistence of hematologic remission.
Results. The AHSCT/imatinib groups included 36/46 patients, average age was 36/46, patients in chronic phase 34/44 and in blastic phase, 2/2. The number of myeloablative/non-myeloablative transplants was 28/8. Imatinib was administered at a dose of 400 to 800 mg/day (median 500 mg). The following events developed in both groups: death 14/3, hematological progression 4/5, 17/41 are alive and in hematological remission (p = 0.00009). The OS probability is 0.42 and 0.76 at 100 months (p = 0.0001). The decrease in absolute risk is 42%. The OS after 17 years remains unmodified in the AHSCT group after the first 6 years.
Conclusion. OS at 100 months is superior with imatinib than with AHSCT (p = 0.0001).
REFERENCES
Moloney WC. History of chronic leukemias. In: Wiernik PH, Canellos GP, Kyle RA, Schiffer CA. Neoplastic diseases of the blood. 2nd. Ed. New York: Churchill Livingstone; 1991, p. 3-5.
Barnett M, Eaves CJ. In: Henderson ES, Lister TA, Greaves MF. Leukemia. 6th. Ed. Philadelphia: WB Saunders Co.; 1996, p. 535-53.
Nowell PC, Hungerford DA. A minute chromosome in human chronic granulocytic leukemia. Science 1960; 132: 1497-508.
Alimena G, Morra E, Lazzarino M, Liberati AM, Montefusco E, Inverardi D, et al. Interferon alpha-2b as therapy for Ph’- positive chronic myelogenous leukemia: a study of 82 patients treated with intermittent or daily administration. Blood 1988; 72: 642-7.
Druker BJ, Tamura S, Buchdunger E, Ohno S, Segal GM, Fanning S, et al. Effects of a selective inhibitor of the Abl tyrosine kinase on the growth of Bcr-Abl positive cells. Nat Med 1996; 2: 561-6.
Savage DG, Antman KH. Imatinib mesylate: a new oral targeted therapy. N Engl J Med 2002; 346: 683-93.
NCCN Practice Guidelines in Oncology. Chronic Myeloid Leukemia v.2.2009. Availabre from: www.nccn.org.
Baccarani M, Saglio G, Goldman J, Hochhaus A, Simonsson B, Appelbaum F, et al. Evolving concepts in the management of chronic myeloid leukemia: recommendations from an expert panel on behalf of the European Leukemia Net. 2009. Available from: www.bloodjournal.org
Baccarani M, Saglio G, Goldman J, Hochhaus A, Simonsson B, Appelbaum F, et al. Evolving concepts in the management of chronic myeloid leukemia: recommendations from an expert panel on behalf of the European LeukemiaNet. Blood 2006; 108: 1809-20.
Vela-Ojeda J, Tripp-Villanueva F, Sánchez-Cortés E, Ayala- Sánchez M, Rosas-Cabral A, Esparza M, et al. Allogeneic bone marrow transplantation for chronic myeloid leukemia: a single center experience. Arch Med Res 2000; 31: 206-9.
Robin M, Guardiola P, Devergie A, Yeshurun M, Shapiro S, Esperou H, et al. A 10-year median follow-up study after allogeneic stem cell transplantation for chronic myeloid leukemia in chronic phase from HLA-identical sibling donors. Leukemia 2005; 19: 1613-20.
Gratwohl A, Brand R, Apperley J, Crawley C, Ruutu T, Corradini P, et al. Allogeneic hematopoietic stem cell transplantation for chronic myeloid leukemia in Europe 2006: transplant activity, long term data and current results: an analysis by the Chronic Leukemia Working Party of the European Group for Blood and Marrow Transplantation (EBMT). Haematologica 2006; 91: 513-21.
Ruiz-Argüelles G, Gómez-Almaguer D, Morales-Toquero A, Gutiérrez-Aguirre CH, Vela-Ojeda J, García-Ruiz-Esparza MA, et al. The early referral for reduced-intensity stem cell transplantation in patients with Ph1 (+) chronic myelogenous leukemia in chronic phase in the imatinib era: results of the Latin American Cooperative Oncohematology Group (LACOHG) prospective, multicenter study. Bone Marrow Transp 2005; 36: 1043-7.
Bornhäeuser M, Kiehl M, Siegert W, Schetelig J, Hertenstein B, Martin H, et al. Dose-reduced conditioning for allografting in 44 patients with chronic myeloid leukaemia: a retrospective analysis. British J Haematol 2001; 115: 119-24.
Crawley C, Szydlo R, Lalacette M, Bacigalupo A, Lange A, Brune M, et al. Outcomes of reduced-intensity transplantation for chronic myeloid leukemia: an analysis of prognostic factors from the Chronic Leukemia Working Party of the EBMT. Blood 2005; 106: 2969-76.
Ruiz-Arguelles GJ, Tarin-Arzaga LC, González-Carrillo ML, Gutiérrez-Riveroll KI, Rangel-Malo R, Gutiérrez-Aguirre CH, et al. Therapeutic choices in patients with Ph-positive CML living in Mexico in the tyrosine kinase inhibitor era: SCT or TKIs? Bone Marrow Transplant 2008; 42: 23-8.
Hahn EA, Glendenning GA, Sorensen MV, Hudgens SA, Druker BJ, Guilhot F, et al. Quality of life in patients with newly diagnosed chronic phase chronic myeloid leukemia on imatinib versus interferon alfa plus low-dose cytarabine: results from the IRIS Study. J Clin Oncol 2003; 21: 2138-246.
Castagnetti F, Palandri F, Amabile M, Testoni N, Luatti S, Soverini S, et al. Results of high-dose imatinib mesylate in intermediate SOKAL risk chronic myeloid leukemia patients in early chronic phase: A phase II trial of the GIMEMA CML WP. Blood 2009; 113: 3428-34.
Hochhaus A, Druker B, Sawyers C, Guilhot F, Schiffer CA, Cortes J, et al. Favorable long-term follow-up results over 6 years for response, survival, and safety with imatinib mesylate therapy in chronic-phase chronic myeloid leukemia after failure of interferon-treatment. Blood 2008; 111: 1039-43.
Cortes JE, Baccarani M, Guilhot F, Druker BJ, Branford S, Kim DW, et al. Phase III, randomized, open-label study of daily imatinib mesylate 400 mg versus 800 mg in patients with newly diagnosed, previously untreated chronic myeloid leukemia in chronic phase using molecular end points: tyrosine kinase inhibitor optimization and selectivity study. J Clin Oncol 2010; 28: 424-30.
Zhang WW, Cortes JE, Yao H, Zhang L, Reddy NG, Jabbour E, et al. Predictors of primary imatinib resistance in chronic myelogenous leukemia are distinct from those in secondary imatinib resistance. J Clin Oncol 2009; 27: 3642-9.
Goldman J. How I treat chronic myeloid leukemia in the imatinib era. Blood 2007; 110: 2828-37.
Alfaro LJ, Cortes-Monroy PB, Cabrera CM, Cao PC, Conte LG, Bello AP, et al. Recomendaciones clínicas mínimas para estudio y tratamiento de leucemia mieloide crónica (LMC). Sociedad Chilena de Hematología, 2008. Disponible en: www.hematologia.org
Combariza JF, Rodríguez M, García J, Acevedo de los Ríos M, Gálvez K, Cardona A, et al. Consenso sobre diagnóstico y tratamiento de leucemia mieloide crónica. Rev Colomb Cancerol 2008; 12: 126-42.
Skrepnek GH, Ballard EE. Cost-efficacy of imatinib versus allogeneic bone marrow transplantation with a matched unrelated donor in the treatment of chronic myelogenous leukemia: a decisión-analytic approach. Pharmacotherapy 2005; 25: 325-34.