1. ¹Centro de Hematología y Medicina Interna, Clinica Ruiz, Puebla, México
2. ²Laboratorios Clínicos de Puebla, Clinica Ruiz, Puebla, México
3. ³Departamento de Hematología, Hospital Universitario, Monterrey, México
4. ⁴Department of Hematology, MD Anderson Cancer Center, Houston, TX, USA

Correspondence: Dr GJ Ruiz-Argüelles, Centro de Hematología y Medicina Interna de Puebla, 8B Sur 3710, Puebla 72530, Mexico. E-mail: gruiz1@clinicaruiz.com

Received 10 October 2007; Revised 10 January 2008; Accepted 16 January 2008.

Abstract

A total of 72 patients with Ph-positive CML in first chronic phase were followed during a 6-year period in two different institutions in México. Among them, 22 were given a reduced-intensity allogeneic SCT, whereas 50 were given a tyrosine kinase inhibitor (TKI), mainly imatinib mesylate. The 6-year overall survival (OS) after the therapeutic intervention for patients allografted or given a TKI was 77 and 84%, respectively (P, NS); the median OS for both groups has not been reached, being above 90 and 71 months, respectively (P, NS). The freedom from progression to blast or accelerated phases was also similar for both groups, as well as the overall OS after diagnosis. Most patients allografted (91%) chose this treatment because they were unable to afford continuing treatment with the TKI, whereas most treated with the TKI (84%) were given the treatment without charge, through institutions able to pay for their treatment. The median cost of each nonmyeloablative allograft was US$18 000, an amount that is enough to cover 180 days of treatment with imatinib (400 mg per day) in México. Cost considerations favor allogeneic SCT as a 'once only' procedure whereas lifelong treatment with an expensive drug represents an excessive burden on resources.