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  • Title: Targeted agents for chronic myelogenous leukemia: will that be the end of allogeneic bone marrow transplantation for that disease?
    Author: Liang Y, Lai Y, Schwarzenberger P, Li Q, Ma J, Luo J, Liu R, Shi L, Zhou J, Peng Z, Yang J, Deng D, Zhou Y.
    Journal: Biol Blood Marrow Transplant; 2010 Jun; 16(6):848-53. PubMed ID: 20138227.
    Abstract:
    Although the drug imatinib has been accepted as the treatment of choice for chronic myelogenous leukemia (CML) in chronic phase (CP) throughout the Western world, allogeneic stem cell transplantation (allo-SCT) continues to remain a widely practiced first-line treatment in countries with limited health care budgets. The rationale is not scientific, but largely economically based. We analyzed a cohort of 46 CML patients who participated in a graft-versus-host disease (GVHD) prophylaxis clinical trial and underwent related HLA-matched allogeneic peripheral blood stem cell transplantation. The median time of follow-up in surviving patients was 43 months (range: 4-89 months). Risk stratification of the population was done by European Blood and Marrow Transplant (EBMT) criteria. The estimated probabilities of overall survival (OS) and leukemia-free survival (LFS) at 3 years in low EBMT risk score (0-2) patients were both 91%, respectively. We conclude that in countries with restricted access to imatinib, allo-SCT should be considered early on as front-line therapy. Continued research support for bone marrow transplantation will be needed to make a global impact on this disease.
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