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; nilotinib 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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Authors | 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 |
Journal | Bone marrow transplantation
(Bone Marrow Transplant)
Vol. 49
Issue 9
Pg. 1146-54
(Sep 2014)
ISSN: 1476-5365 [Electronic] England |
PMID | 25046218
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Protein Kinase Inhibitors
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Topics |
- Adolescent
- Adult
- Combined Modality Therapy
- Female
- Hematopoietic Stem Cell Transplantation
(methods)
- Humans
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive
(drug therapy, therapy)
- Male
- Middle Aged
- Protein Kinase Inhibitors
(therapeutic use)
- Retrospective Studies
- Transplantation Conditioning
(methods)
- Treatment Outcome
- Young Adult
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