Response to imatinib in patients who relapse after allogeneic stem cell transplantation for chronic myeloid leukemia

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Abstract

We studied 128 patients with chronic myeloid leukemia (CML) relapsing after allogeneic stem cell transplantation (SCT). Disease at the time of treatment with Imatinib was in chronic phase (CP) in 51 patients, accelerated phase (AP) in 31 and blastic crisis (BC) in 46. Of the 51 patients in CP, 14 were in cytogenetic and two in molecular relapses. The median interval between relapse and Imatinib therapy was 5 months (0–65). A total of 50 patients had failed treatment with donor lymphocyte infusions prior to Imatinib. The overall hemato-logical response rate was 84% (98% for patients relapsing in CP). The complete cytogenetic response (CCR) was 58% for patients in CP, 48% for AP and 22% for patients in BC. Complete molecular responses were obtained in 25 patients (26%), of whom 21 were in CP or AP. With a median follow-up of 9 months, the estimated 2-year survival for CP, AP and BC patients was 100, 86 and 12%, respectively. Out of 79 evaluable patients, 45 (57%) achieved full donor and 11 (14%) mixed chimerism after Imatinib. We conclude that Imatinib has significant activity against CML in relapse after allogeneic SCT. Durable cytogenetic and molecular remissions are obtainable in patients in CP.

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Acknowledgements

List of participating centers: Univ. Klinik fur Innere Medizin I, Vienna (Lechner); Princess Margaret Hospital, Toronto (Lipton); Chaim Sheba Medical Center, Tel Hashomer (Nagler); Hospital Virgen del rocio, Sevilla (Parody); University ‘La Sapienza’, Rome (Guglielmi); Azienda Ospedaliera ‘Bianchi-Melacrino-Morelli’, Reggio-Calabria (Iacopino); Institute of Hematology and Blood Transfusion, Prague (Vitek); Hôpital St Louis, Paris (Rousselot); University Hospital, Olomouc (Indrak, Faber); Nottingham City Hospital, Nottingham (Byrne); Royal Victoria Infirmary, Newcastle (O'Brien); Hotel Dieu, Nantes (Harousseau); III Med Klinik der TU Klinkum Rechts der Isar, München (Schneller); Johannes Gutenberg-Universität, Mainz (Fischer); Hospital de La Princesa, Madrid (Steegman); Hopital E Herriot, Lyon (Michallet); Hammersmith Hospital, London (Olavarria); Royal Liverpool University Hospital, Liverpool (Clark); University of Leipzig, Leipzig (Deininger, Niederwieser); Hadassah University Hospital, Jerusalem (Ben Yehuda); University of Idar-Oberstein, Idar-Oberstein (Basara); Huddinge University Hospital, Huddinge (Ljungman); Universität Frankfurt, Frankfurt (Ottmann); Bristol Royal Hospital for Children, Bristol (Marks); University of Brisbane, Brisbane (Taylor); Hôpital Haut-leveque, Bordeaux (Perreau, Cony-Makhoul); Hospital San Orsola, Bologna (Bandini); Virchow-Klinikum, Berlin (Sieger, Le Coutre); Kantonsspital, Basel (Hechm); Hospital Clinic, Barcelona (Cervantes); Royal Adelaide Hospital, Adelaide (Hughes); Grampian University Hospitals, Aberdeen (Culligan).

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Correspondence to E Olavarria.

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Olavarria, E., Ottmann, O., Deininger, M. et al. Response to imatinib in patients who relapse after allogeneic stem cell transplantation for chronic myeloid leukemia. Leukemia 17, 1707–1712 (2003) doi:10.1038/sj.leu.2403068

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Keywords

  • imatinib
  • stem cell transplantation
  • CML
  • relapse

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