1. ¹Division of Pediatric Hematology/Oncology/Blood and Marrow Transplantation, University of Minnesota, Minneapolis, MN, USA
2. ²Division of Biostatistics, University of Minnesota, Minneapolis, MN, USA
3. ³Division of Hematology/Oncology/Blood and Marrow Transplantation, University of Minnesota, Minneapolis, MN, USA

Correspondence: Dr MJ Burke, Division of Hematology/Oncology/Blood and Marrow Transplantation, Department of Pediatrics, University of Minnesota, MMC484, D-557 Mayo Building, 420 Delaware St, SE, Minneapolis, MN 55455, USA. E-mail: burke283@umn.edu

Received 3 September 2008; Revised 4 December 2008; Accepted 8 December 2008; Published online 9 February 2009.

Abstract

Since the introduction of imatinib mesylate, the role of allogeneic hematopoietic cell transplantation (allo-HCT) for CML has essentially been reserved for patients with advanced disease or imatinib resistance. In addition, there have been concerns regarding imatinib associated cardiac toxicity. We investigated the outcome of 61 patients with CML who received a myeloablative allo-HCT at the University of Minnesota between 1999 and 2006. The median age at HCT was 38.4 (range; 6.9–56.9) years. Thirty-seven patients were in first chronic phase and twenty-four patients in a second chronic or accelerated phase at the time of HCT. Twenty-six patients received imatinib therapy before or after HCT, and thirty-five patients either never received imatinib (n=32) or received it only at the time of relapse after HCT (n=3). OS and relapse-free survival (RFS) at 2 years was 69 and 55% for the imatinib group, and 57 and 49% for the non-imatinib group (P=0.57 and 0.95, respectively). There was no difference in the risk of relapse at 2 years between the groups. Symptomatic cardiac toxicity at 1 year was reported in three imatinib group (12%) and two non-imatinib group (6%) patients (P=0.44). Thus, patients treated with imatinib either before or after myeloablative allo-HCT had no increase in cardiac toxicity.