Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Letter to the Editor
  • Published:

Outcome of patients with chronic myeloid leukemia and a low-risk score: allogeneic hematopoietic stem cell transplantation in the era of targeted therapy. A report from the EBMT Chronic Malignancies Working Party

Bone Marrow Transplantation volume 51, pages 1259–1261 (2016)Cite this article

Subjects

Hematopoietic stem cell transplantation (HSCT) was introduced as treatment for patients with CML in chronic phase (CP) in the late 1970's.1 Transplantation of bone marrow cells from syngeneic donors after high-dose chemotherapy made successful eradication of the Philadelphia positive clone possible. HSCT gained rapid acceptance. By 1999, CML was the most frequent indication for an allogeneic HSCT worldwide. The introduction of tyrosine kinase inhibitors (TKIs) into clinical practice led to declined transplant rates. Expert guidelines do not recommend HSCT as first-line therapy in CP-CML anymore.2, 3 Only patients who are resistant to at least one 2nd generation TKI are HSCT candidates.2 Despite its potential to keep a large number of patients free of the disease for >25 years, early transplant-related mortality is considered too high to justify HSCT as a treatment option.

Only a few studies reported on outcomes of HSCT patients with a suboptimal or failed response to TKI.4, 5, 6 These studies include a mixed group of high and low-risk patients and cannot be considered as a representative. Data on a large patient cohort are lacking. We were therefore especially interested in outcome of patients with low-risk transplants as defined by the European Society of Blood and Marrow Transplantation (EBMT) risk score7 and transplanted with standard optimal procedures in the tyrosine kinase era.

This is a preview of subscription content, access via your institution

Relevant articles

Open Access articles citing this article.

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2

References

  1. Clift RA, Buckner CD, Thomas ED, Doney K, Fefer A, Neiman PE et al. Treatment of chronic granulocytic leukaemia in chronic phase by allogeneic marrow transplantation. Lancet 1982; 2: 621–623.

    Article  CAS  PubMed  Google Scholar 

  2. Baccarani M, Deininger MW, Rosti G, Hochhaus A, Soverini S, Apperley JF et al. European LeukemiaNet recommendations for the management of chronic myeloid leukemia. Blood 2013; 122: 872–884.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Barrett AJ, Ito S . The role of stem cell transplantation for chronic myelogenous leukemia in the 21st century. Blood 2015; 125: 3230–3235.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Saussele S, Lauseker M, Gratwohl A, Beelen DW, Bunjes D, Schwerdtfeger R et al. Allogeneic hematopoietic stem cell transplantation (allo SCT) for chronic myeloid leukemia in the imatinib era: evaluation of its impact within a subgroup of the randomized German CML Study IV. Blood 2010; 115: 1880–1885.

    Article  CAS  PubMed  Google Scholar 

  5. Warlick E, Ahn KW, Pedersen TL, Artz A, de Lima M, Pulsipher M et al. Reduced intensity conditioning is superior to nonmyeloablative conditioning for older chronic myelogenous leukemia patients undergoing hematopoietic cell transplant during the tyrosine kinase inhibitor era. Blood 2012; 119: 4083–4090.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Pavlu J, Szydlo RM, Goldman JM, Apperley JF . Three decades of transplantation for chronic myeloid leukemia: what have we learned? Blood 2011; 117: 755–763.

    Article  CAS  PubMed  Google Scholar 

  7. Gratwohl A, Hermans J, Goldman JM, Arcese W, Carreras E, Devergie A et al. Risk assessment for patients with chronic myeloid leukaemia before allogeneic blood or marrow transplantation. Chronic Leukemia Working Party of the European Group for Blood and Marrow Transplantation. Lancet 1998; 352: 1087–1092.

    Article  CAS  PubMed  Google Scholar 

  8. Gray RJ . A Class of K-Sample Tests for Comparing the Cumulative Incidence of a Competing Risk. Ann Stat 1988; 16: 1141–1154.

    Article  Google Scholar 

  9. Gratwohl A, Brand R, Apperley J, Crawley C, Ruutu T, Corradini P et al. Allogeneic hematopoietic stem cell transplantation for chronic myeloid leukemia in Europe 2006: transplant activity, long-term data and current results. Haematologica 2006; 91: 513–521.

    PubMed  Google Scholar 

Download references

Acknowledgements

The cooperation of all participating teams and their staff (listed after the Reference section) and the Chronic Malignancies Working Party Registry (AvB) is greatly appreciated.

Author information

Authors and Affiliations

  1. Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany

    C Koenecke & M Heuser

  2. Department of Medicine and Hematology, University Hospital, Basel, Switzerland

    D Heim

  3. Department of Medical Statistics & BioInformatics, LUMC, Leiden, The Netherlands

    A van Biezen

  4. Department of Hematology, King Faisal Specialist Hospital, Riyadh, Saudi Arabia

    M Aljurf

  5. Department of Hematology, Silesian Medical Academy University, Katowice, Poland

    S Kyrcz-Krzemien

  6. Stem Cell Transplantation Unit, Helsinki University Central Hospital, Helsinki, Finland

    L Volin

  7. Cidade Universitaria ‘Zeferino Vaz’, Campinas SP, Brazil

    C A de Souza

  8. Department of Medicine,

    T Gedde-Dahl

  9. Rikshospitalet,

    T Gedde-Dahl

  10. The National Hospital, Oslo, Norway

    T Gedde-Dahl

  11. BMT Unit, Rigshospitalet, Copenhagen, Denmark

    H Sengeloev

  12. Division of Medicine, University Hospital, Zürich, Switzerland

    U Schanz

  13. Department of Hematology, K Marcinkowski University of Medical Science, Poznań, Poland

    M Komarnicki

  14. Department of Hematology, Hospital Reina Sofia Córdoba, Córdoba, Spain

    C H Arroyo

  15. Department of Hematology, Manchester Royal Infirmary, Manchester, UK

    E Tholouli

  16. Department of Hematology, Hopital St Louis, Paris, France

    E Gluckman

  17. Hospital Santa Creu I Sant Pau, Barcelona, Spain

    A Esquirol

  18. LIRIC INSERM U995, Université Lille 2,

    I Yakoub-Agha

  19. CHRU de Lille, Lille, France

    I Yakoub-Agha

  20. Department of Hematology, Ankara University School of Medicine, Ankara, Turkey

    G Gürman

  21. Department of Haematology, Imperial College, Hammersmith Hospital, London, UK

    E Olavarria

  22. Department of Stem Cell Transplantation, University Hospital Eppendorf, Hamburg, Germany

    N Kröger

Authors
  1. C Koenecke
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. D Heim
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A van Biezen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M Heuser
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. M Aljurf
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. S Kyrcz-Krzemien
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. L Volin
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. C A de Souza
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. T Gedde-Dahl
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. H Sengeloev
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. U Schanz
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. M Komarnicki
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. C H Arroyo
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. E Tholouli
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. E Gluckman
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. A Esquirol
    View author publications

    You can also search for this author in PubMed Google Scholar

  17. I Yakoub-Agha
    View author publications

    You can also search for this author in PubMed Google Scholar

  18. G Gürman
    View author publications

    You can also search for this author in PubMed Google Scholar

  19. E Olavarria
    View author publications

    You can also search for this author in PubMed Google Scholar

  20. N Kröger
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to C Koenecke.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Appendix

Appendix

List of participating teams:

M Rovira20, P Kahls21, A Alegre22, D Nemet23, D Stamatovic24, A Vitek25, R Hamladji26, A Hellmann27, A Chybicka28, W Wiktor-Jedrzejczak29, A Maiolino30, P von dem Borne31, P Chevallier32, T Littlewood33, C Crawley34, M Mistrik35, K Schäfer-Eckart36, K Orchard37, J Maertens38, M van Lint39, M Ethell40, K Vettenranta41, A Broom42, E Deconinck43, N Schaap44, E Petersen45, CR Espiga46, P Di Bartolomeo47, P Brown48, D Beelen49, V Leblond50, X Leleu51, K Carlson52, N Milpied53, M Collin54, J Johansson55, R Cairoli56, H Serwe57, M Schleuning58, M Ozturk59, IA Lisukov60, S Robinson61, D Uckan-Cetinkaya62, P Rohrlich63, G Visani64, F Merli65, M Sanz66, M Michallet67, K Halaburda68, T O’Brien69, P Jindra70, L Feldman71, M Theobald72, C Favre73, F Rodeghiero74, J Finke75

20Hospital Clinic, Barcelona, Spain, 21Medizinische Universitaet Wien, Vienna, Austria, 22Hospital de la Princesa, Madrid, Spain, 23University Hospital Center – Rebro, Zagreb, Croatia, 24Military Medical Academy, Belgrade, Serbia and Montenegro, 25Inst. of Hematology and Blood Transf., Prague, Czech Republic, 26Centre Pierre et Marie Curie, Alger, Algeria, 27Medical University of Gdansk, Gdansk, Poland, 28Wroclaw Medical University, Wroclaw, Poland, 29The Medical University of Warsaw, Warsaw, Poland, 30Univ. Fed. do Rio de Janeiro, Rio de Janeiro Ilha do Fundão, Brazil, 31Leiden University Hospital, Leiden, The Netherlands, 32Hotel Dieu, Nantes, France, 33The Oxford Radcliffe Hospital, Oxford, UK, 34Addenbrookes Hospital, Cambridge, UK, 35Univ. Hosp. Clinic of Hemat. & Transfusiology, Bratislava, Slovakia, 36Klinikum Nürnberg, Nürnberg, Germany, 37Southampton General Hospital, Southampton, UK, 38University Hospital of Leuven, Leuven, Belgium, 39Ospedale San Martino, Genova, Italy, 40Royal Marsden Hospital, Sutton, UK, 41University of Helsinki, Helsinki, Finland, 42Western General Hospital, Edinburgh, Scotland, UK, 43Hopital Jean Minjoz, Besancon, France, 44Univ. Med. Cent. St Radboud, Nijmegen, The Netherlands, 45University Medical Centre Utrecht, Utrecht, The Netherlands, 46Hospital Univ. ‘Marqués de Valdecilla’, Santander, Spain, 47Ospedale Civile, Pescara, Italy, 48St James Hospital Trinity College, Dublin, Ireland, 49University Hospital, Essen, Germany, 50Pitie-Salpetriere, Paris, France, 51Hopital La Miletrie, Poitiers, France, 52University Hospital, Uppsala, Sweden, 53Hopital Haut-Leveque, Pessac, France, 54Royal Victoria Infirmary, Newcastle-upon-Tyne, UK, 55Sahlgrenska University Hospital, Goeteborg, Sweden, 56Ospedale di Niguarda Ca’Granda, Milano, Italy, 57Universität Frankfurt, Frankfurt, Germany, 58Deutsche Klinik für Diagnostik, Wiesbaden, Germany, 59Gulhane Military Medical Academy, Ankara, Turkey, 60Institute of Clinical Immunology, Novosibirsk, Russia, 61Bristol Royal Hospital for Children, Bristol, UK, 62Hacettepe University Childrens Hospital, Ankara, Turkey, 63Hôpital de l’Arget, Nice, France, 64Pesaro Hospital, Pesaro, Italy, 65Arcispedale S Maria Nuova Unita Oper. Emat., Reggio Emilia, Italy, 66Hospital Universitario La Fe,Valencia, Spain, 67Hopital E Herriot, Lyon, France, 68Institute of Haematology and Blood Transfusion, Warsaw, Poland, 69Sydney Children’s Hospital, Randwick, NSW, Australia, 70Charles University Hospital, Pilsen, Czech Republic, 71Antartida Hospital Privado, Buenos Aires, Argentina, 72University Medical Center Mainz, Mainz, Germany, 73Unità Operativa Oncoematologia Pediatrica, Pisa, Italy, 74S Bortolo Hospital, Vicenza, Italy, 75University Hospital Freiburg, Freiburg, Germany.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Koenecke, C., Heim, D., van Biezen, A. et al. Outcome of patients with chronic myeloid leukemia and a low-risk score: allogeneic hematopoietic stem cell transplantation in the era of targeted therapy. A report from the EBMT Chronic Malignancies Working Party. Bone Marrow Transplant 51, 1259–1261 (2016). https://doi.org/10.1038/bmt.2016.97

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/bmt.2016.97

This article is cited by

Search

Advanced search

Quick links