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Chronic Leukemia

Allogeneic hematopoietic SCT in combination with tyrosine kinase inhibitor treatment compared with TKI treatment alone in CML blast crisis

Bone Marrow Transplantation volume 49, pages 1146–1154 (2014)Cite this article

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Abstract

CML treatment with tyrosine kinase inhibitors (TKIs) has improved many patients’ prognosis, but during the disease’s terminal phase, the blast crisis (CML-BC), has been disappointing. Allo-HSCT is another treatment, but survival rates are still disappointing. Currently, a combination of these two is suggested but with little evidence. This retrospective comparison reports on this combination and TKI alone for treatment of CML-BC. Of the 83 CML-BC patients, 45 received TKIs (imatinib; nilotinb or dasatinib after imatinib resistance; TKIs group) and 38 were treated with allo-HSCT after TKI (TKIs+allo-HSCT group). Treatment success was measured in terms of the hematologic, cytogenic and molecular responses, and subject outcome. Follow-up was 30–126 months or until death. Univariate and multivariate analyses determined EFS and OS predictors. Allo-HSCT significantly improved the 4-year OS (46.7 vs 9.7%, P<0.001) and EFS (47.1 vs 6.7%, P<0.001) compared to TKI treatment alone. Hemoglobin <100 g/L, non-return to chronic phase after TKI therapy and TKI treatment alone are independent adverse predictors of OS and EFS. Allo-HSCT with individualized intervention after TKI therapy is superior to TKI alone for CML-BC.

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Acknowledgements

We would like to thank the contributions of all the people who have participated in this research. This includes our laboratory staff, our colleagues and our nurses. The study was supported by the National Outstanding Young Scientists’ Foundation of China (grant no. 30725038) and by the Program for Innovative Research Team at the University of China (grant no. IRT0702). The study was also supported by the Collaborative Innovation Center of Hematology, China.

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  1. H Jiang and L-P Xu: These authors contributed equally to this work.

Authors and Affiliations

  1. Peking University People’s Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China

    H Jiang, L-P Xu, D-H Liu, K-Y Liu, S-S Chen, B Jiang, Q Jiang, H Chen, Y-H Chen, W Han, X-H Zhang, Y Wang, J-Z Wang, F-R Wang, Y-Z Qin, Y-Y Lai & X-J Huang

  2. Peking-Tsinghua Center for Life Sciences, Beijing, China

    X-J Huang

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Correspondence to X-J Huang.

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Jiang, H., Xu, LP., Liu, DH. et al. Allogeneic hematopoietic SCT in combination with tyrosine kinase inhibitor treatment compared with TKI treatment alone in CML blast crisis. Bone Marrow Transplant 49, 1146–1154 (2014). https://doi.org/10.1038/bmt.2014.146

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