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Trial of IFN or STI571 before proceeding to allografting for CML?

Abstract

Ten-year survival of IFN-treated low risk CML patients is about 40%, and more in cytogenetic responders. Allografting has a cure rate of up to 75%, but is associated with considerable procedure related morbidity and mortality. One out of three or four is likely not to survive. A comparative quantification of survival after BMT and IFN treatment suggests that a trial of IFN (and possibly STI 571) before proceeding to allografting is a viable, and in low risk patients a probably preferable option.

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References

  1. Hansen JA, Gooley TA, Martin PJ, Appelbaum F, Chauncey TR, Clift RA, Petersdorf EW, Radich J, Sanders JE, Storb RF, Sullivan KM, Anasetti C . Bone marrow transplants from unrelated donors for patients with chronic myeloid leukemia New Engl J Med 1998 338: 962–968

    Article  CAS  Google Scholar 

  2. Hehlmann R, Heimpel H, Hasford J, Kolb HJ, Pralle H, Hossfeld DK, Queisser W, Löffler H, Hochhaus A, Heinze B, Georgii A, Bartram CR, Griesshammer M, Bergmann L, Essers U, Falge C, Queisser U, Meyer P, Schmitz N, Eimermacher H, Walther F, Fett W, Kleeberg UR, Käbisch A, Nerl C, Zimmermann R, Meuret G, Tichelli A, Kanz L, Tigges FJ, Schmid L, Brockhaus W, Tobler A, Reiter A, Perker M, Emmerich B, Verpoort K, Zankovich R, von Wussow P, Prümmer O, Thiele J, Buhr T, Carbonell F, Ansari H, and the German CML Study Group . Randomized comparison of interferon-alpha with busulfan and hydroxyurea in chronic myelogenous leukemia Blood 1994 84: 4064–4077

    CAS  PubMed  Google Scholar 

  3. Hasford J, Pfirrmann M, Hehlmann R, Allan NC, Baccarani M, Kluin-Nelemans J, Alimena G, Steegmann JL, Ansari H . A new prognostic score for the survival of patients with chronic myeloid leukemia treated with interferon alfa J Natl Cancer Inst 1998 90: 850–858

    Article  CAS  Google Scholar 

  4. Appelbaum FR, Clift R, Radich J, Anasetti C, Buckner CD . Bone marrow transplantation for chronic myelogenous leukemia Semin Oncol 1995 22: 405–411

    CAS  PubMed  Google Scholar 

  5. van Rhee F, Szydlo RM, Hermans J, Devergie A, Frassoni F, Arcese W, de Witte T, Kolb HJ, Niederwieser D, Jacobsen N, Gahrton G, Bandini G, Carreras E, Bacigalupo A, Michallet M, Ruutu T, Reiffers J, Goldman JM, Apperley J, Gratwohl A, Apperley JF, Labopin M, Madrigal A, Prentice HG, Jouet JP, Hertenstein B, Evensen SA, Ljungman P, Nagler A, Clark RE . Long-term results after allogeneic bone marrow transplantation for chronic myelogenous leukemia in chronic phase: a report from the Chronic Leukemia Working Party of the European Group for Blood and Marrow Transplantation European results of matched unrelated donor bone marrow transplantation for chronic myeloid leukemia. Impact of HLA class II matching. Chronic Leukemia Working Party of the European Group for Blood and Marrow Transplantation Bone Marrow Transplant 1997 20: 11–19

    Article  Google Scholar 

  6. Gale RP, Hehlmann R, Zhang M-J, Hasford J, Goldman JM, Heimpel H, Hochhaus A, Klein JP, Kolb HJ, McGlave PB, Passweg JR, Rowlings PA, Sobocinski KA, Horowitz MM and the German CML Study Group . Survival with bone marrow transplantation versus hydroxyurea or interferon for chronic myelogenous leukemia Blood 1998 91: 1810–1819

    CAS  PubMed  Google Scholar 

  7. Silver RT, Woolf SH, Hehlmann R, Appelbaum FA, Anderson J, Bennett C, Goldman JM, Guilhot F, Kantarjian HM, Lichtin AE, Talpaz M, Tura S . Review: an evidence-based analysis of the effect of busulfan, hydroxyurea, interferon, and allogeneic bone marrow transplantation in treating the chronic phase of chronic myeloid leukemia: developed for the American Society of Hematology Blood 1999 94: 1517–1536

    CAS  PubMed  Google Scholar 

  8. Hehlmann R, Hochhaus A, Kolb HJ, Hasford J, Gratwohl A, Heimpel H, Siegert W, Finke J, Ehninger G, Holler E, Berger U, Pfirrmann M, Muth A, Zander A, Fauser AA, Heyll A, Nerl C, Hossfeld DK, Löffler H, Pralle H, Queisser W, Tobler A, for the German CML-Study Group and the SAKK . Interferon α before allogeneic bone marrow transplantation in chronic myelogenous leukemia does not affect outcome adversely, provided it is discontinued at least 90 days before the procedure Blood 1999 94: 3668–3677

    CAS  PubMed  Google Scholar 

  9. ICSG on CML . Long-term follow-up of the Italian trial of interferon-α versus conventional chemotherapy in chronic myeloid leukemia Blood 1998 92: 1541–1548

    Google Scholar 

  10. Druker BJ, Talpaz M, Resta D, Peng B, Buchdunger E, Ford J, Sawyers CL . Clinical efficacy and safety of an abl specific tyrosine kinase inhibitor as targeted therapy for chronic myelogenous leukemia Blood 1999 94: (Suppl. 1) 368a

    Google Scholar 

  11. Goldman JM, Szydlo R, Horowitz MM, Gale RP, Ash RC, Atkinson K, Dicke KA, Gluckman E, Herzig RH, Marmont A . Choice of pretransplant treatment and timing of transplants for chronic myelogenous leukemia in chronic phase Blood 1993 82: 2235–2238

    CAS  PubMed  Google Scholar 

  12. Thijsen SFT, Schuurhuis GJ, van Oostveen JW, Ossenkoppele GJ . Chronic myeloid leukemia from basics to bedside Leukemia 1999 13: 1646–1674

    Article  CAS  Google Scholar 

  13. Duesberg P, Rausch C, Rasnick D, Hehlmann R . Genetic instability of cancer cells is proportional to their degree of aneuploidy Proc Natl Acad Sci USA 1998 95: 13692–13697

    Article  CAS  Google Scholar 

  14. Giralt SA, Kantarjian HM, Talpaz M, Rios MB, Del Giglio A, Andersson BS, Przepiorka D, Deisseroth AB, Champlin RE . Effect of prior interferon alfa therapy on the outcome of allogeneic bone marrow transplantation for chronic myelogenous leukemia J Clin Oncol 1993 11: 1055–1061

    Article  CAS  Google Scholar 

  15. Giralt S, Szydlo R, Goldman JM, Veum-Stone J, Biggs JC, Herzig RH, Klein JP, McGlave PB, Schiller G, Gale RP, Rowlings PA, Horowitz MM . Effect of short-term interferon therapy on the outcome of subsequent HLA-identical sibling bone marrow transplantation for chronic myelogenous leukemia: an analysis from the international bone marrow transplant registry Blood 2000 95: 410–415

    CAS  PubMed  Google Scholar 

  16. Zuffa E, Bandini G, Bonini A, Santucci MA, Martinelli G, Rosti G, Testoni N, Zaccaria A, Tura S . Prior treatment with alpha-interferon does not adversely affect the outcome of allogeneic BMT in chronic phase chronic myeloid leukemia Haematologica 1998 83: 231–236

    CAS  PubMed  Google Scholar 

  17. Shepherd P, Richards S, Allan N . Survival after allogeneic bone marrow transplantation (BMT) in patients randomised into a trial of IFN-α versus chemotherapy: no significant adverse effect of prolonged IFN-α administration Blood 1995 86: (Suppl. 1) 94a

    Google Scholar 

  18. Tomas JT, Lopez-Lorenzo JL, Requena MJ, Aguilar R, Steegmann JL, Camara R, Alegre A, Arranz R, Figuera A, Fernandez-Ranada JM . Absence of influence of prior treatment with interferon on the outcome of allogeneic bone marrow transplantation for chronic myeloid leukemia Bone Marrow Transplant 1998 22: 47

    Article  CAS  Google Scholar 

  19. Beelen DW, Graeven U, Elmaagacli AH, Niederle N, Kloke O, Opalka B, Schaefer UW . Prolonged administration of interferon-alpha in patients with chronic-phase Philadelphia chromosome-positive chronic myelogenous leukemia before allogeneic bone marrow transplantation may adversely affect transplant outcome Blood 1995 85: 2981–2990

    CAS  PubMed  Google Scholar 

  20. Morton AJ, Gooley T, Hansen JA, Appelbaum FR, Bruemmer B, Bjerke JW, Clift R, Martin PJ, Petersdorf EW, Sanders JE, Storb R, Sullivan KM, Woolfrey A, Anasetti C . Association between pretransplant interferon-α and outcome after unrelated donor marrow transplantation for chronic myelogenous leukemia in chronic phase Blood 1998 92: 394–401

    CAS  PubMed  Google Scholar 

  21. Gratwohl A, Hermans J, Goldman JM, Frassoni F, Devergie A, Carreras E, Kolb HJ, Gahrton G, Arcese W, Vernant JP, Ruutu T, de Witte T, van Rhee F, Apperley J, for the Chronic Leukemia Working Party of the European Group for Blood and Marrow Transplantation (EBMT) . Risk assessment for patients with chronic myeloid leukemia before allogeneic blood or marrow transplantation Lancet 1998 352: 1087–1092

    Article  CAS  Google Scholar 

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Acknowledgements

This work was supported by grants from the German Bundesminister für Bildung und Forschung: Kompetenznetzwerk ‘Akute und chronische Leukämien’, from the Süddeutsche Hämoblastosegruppe (SHG) through a grant from Hoffmann-La Roche to the SHG, and from the Forschungsfonds der Fakultät für Klinische Medizin, Mannheim.

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Hehlmann, R. Trial of IFN or STI571 before proceeding to allografting for CML?. Leukemia 14, 1560–1562 (2000). https://doi.org/10.1038/sj.leu.2401874

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