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Allografting

Imatinib therapy prior to myeloablative allogeneic stem cell transplantation

Bone Marrow Transplantation volume 36, pages 417–424 (2005)Cite this article

Summary:

It is unknown whether imatinib prior to myeloablative haematopoietic stem cell transplantation (HSCT) increases transplant-related toxicity. Among the side effects induced by imatinib, myelosuppression and liver injury might worsen HSCT outcomes. We retrospectively analysed engraftment, liver toxicity, acute graft-versus-host disease (aGVHD) incidence and 100-day mortality in 30 patients with BCR/ABL-positive leukaemias who received imatinib before HSCT and compared results of 48 age-matched controls who did not receive preceding imatinib. Both neutrophil and platelet engraftment occurred more rapidly among imatinib patients but the differences adjusted for Gratwohl scale were not statistically significant (P=0.18 and 0.22, respectively). The adjusted hazards of having liver function tests (LFTs) >1.5 normal increased and the adjusted durations of elevated LFTs were not significantly different. The estimated adjusted difference in mean peak bilirubin values was also not significantly different (P=0.48). However, the adjusted hazard of increased creatinine >1.5 normal was significantly higher in the imatinib group (HR=4.09, P=0.02). The adjusted odds of grades II–IV aGVHD were similar in both groups (OR=0.86, P=0.78), and while the adjusted odds of 100-day mortality were lower among imatinib patients, the difference was not significant (OR=0.65, P=0.60). These data do not provide any evidence that imatinib preceding HSCT increases acute transplant-related toxicities.

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Acknowledgements

We appreciate the work of the staff that provided the excellent care to all patients.

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Authors and Affiliations

  1. Department of Hematology, Medical University of Gdańsk, Gdańsk, Poland

    J M Zaucha, W Prejzner, D Szatkowski, J Balon & A Hellmann

  2. Department of Haematology and Bone Marrow Transplantation, Silesian Medical University in Katowice, Katowice, Poland

    S Giebel, J Wojnar,  T Krużel & J Hołowiecki

  3. Clinical Research Division, Fred Hutchinson Cancer Research Centre, Seattle, WA, USA

    T A Gooley

  4. Department of Children Haematology and Oncology, Wrocław Medical University, Wrocław, Poland

    K Kałwak

  5. Polish Adult Leukaemia Group, CML Study Section,

    J M Zaucha, W Prejzner, S Giebel, J Wojnar,  T Krużel, J Hołowiecki & A Hellmann

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  1. J M Zaucha
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Correspondence to J M Zaucha.

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Zaucha, J., Prejzner, W., Giebel, S. et al. Imatinib therapy prior to myeloablative allogeneic stem cell transplantation. Bone Marrow Transplant 36, 417–424 (2005). https://doi.org/10.1038/sj.bmt.1705087

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  • DOI: https://doi.org/10.1038/sj.bmt.1705087

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