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Hu B, Lin X, Lee HC, Huang X, Tidwell RSS, Ahn KW, Hu ZH, Jabbour E, Verstovsek S, Ravandi F, Garcia-Manero G, Kharfan-Dabaja MA, Hossain NM, Marks DI, Kamble RT, Inamoto Y, Kindwall-Keller T, Saad A, Litzow MR, Savani BN, Hale GA, Bacher U, Gerds AT, Liesveld JL, Ustun C, Olsson RF, Daly A, Grunwald MR, Solh M, DeFilipp Z, Aljurf M, Wirk B, Akpek G, Nishihori T, Cerny J, Seo S, Hsu JW, Champlin R, de Lima M, Alyea E, Popat U, Sobecks R, Scott BL, Kantarjian H, Cortes J, Saber W. Timing of allogeneic hematopoietic cell transplantation (alloHCT) for chronic myeloid leukemia (CML) patients. Leuk Lymphoma 2020; 61:2811-2820. [PMID: 32662346 DOI: 10.1080/10428194.2020.1783444] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
While TKI are the preferred first-line treatment for chronic phase (CP) CML, alloHCT remains an important consideration. The aim is to estimate residual life expectancy (RLE) for patients initially diagnosed with CP CML based on timing of alloHCT or continuation of TKI in various settings: CP1 CML, CP2 + [after transformation to accelerated phase (AP) or blast phase (BP)], AP, or BP. Non-transplant cohort included single-institution patients initiating TKI and switched TKI due to failure. CIBMTR transplant cohort included CML patients who underwent HLA sibling matched (MRD) or unrelated donor (MUD) alloHCT. AlloHCT appeared to shorten survival in CP1 CML with overall mortality hazard ratio (HR) for alloHCT of 2.4 (95% CI 1.2-4.9; p = .02). In BP CML, there was a trend toward higher survival with alloHCT; HR = 0.7 (0.5-1.1; p = .099). AlloHCT in CP2 + [HR = 2.0 (0.8-4.9), p = .13] and AP [HR = 1.1 (0.6-2.1); p = .80] is less clear and should be determined on a case-by-case basis.
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Affiliation(s)
- Bei Hu
- Department of Lymphoma/Myeloma, UT MD Anderson Cancer Center, Houston, TX, USA.,Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute/Atrium Health, Charlotte, NC, USA
| | - Xiao Lin
- Department of Lymphoma/Myeloma, UT MD Anderson Cancer Center, Houston, TX, USA.,Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, Juangsu Sheng, China
| | - Hans C Lee
- Department of Lymphoma/Myeloma, UT MD Anderson Cancer Center, Houston, TX, USA
| | - Xuelin Huang
- Department of Biostatistics, MD Anderson Cancer Center, Houston, TX, USA
| | | | - Kwang Woo Ahn
- Department of Medicine, Medical College of Wisconsin, CIBMTR (Center for International Blood and Marrow Transplant Research), Milwaukee, WI, USA.,Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Zhen-Huan Hu
- Department of Medicine, Medical College of Wisconsin, CIBMTR (Center for International Blood and Marrow Transplant Research), Milwaukee, WI, USA
| | - Elias Jabbour
- Department of Lymphoma/Myeloma, UT MD Anderson Cancer Center, Houston, TX, USA
| | - Srdan Verstovsek
- Department of Lymphoma/Myeloma, UT MD Anderson Cancer Center, Houston, TX, USA
| | - Farhad Ravandi
- Department of Lymphoma/Myeloma, UT MD Anderson Cancer Center, Houston, TX, USA
| | | | - Mohamed A Kharfan-Dabaja
- Division of Hematology-Oncology, Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, FL, USA
| | - Nasheed M Hossain
- Loyola University Chicago-Stritch School of Medicine, Maywood, IL, USA
| | - David I Marks
- Adult Bone Marrow Transplant, University Hospitals Bristol NHS Trust, Bristol, UK
| | - Rammuriti T Kamble
- Division of Hematology and Oncology, Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX, USA
| | - Yoshihiro Inamoto
- Divsion of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - Tamila Kindwall-Keller
- Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA, USA
| | - Ayman Saad
- Division of Hematology, The Ohio State University, Columbus, OH, USA
| | - Mark R Litzow
- Division of Hematology and Transplant Center, Mayo Clinic Rochester, Rochester, MN, USA
| | - Bipin N Savani
- Divsion of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Gregory A Hale
- Department of Hematology/Oncology, Johns Hopkins All Children's Hospital, Petersburg, FL, USA
| | - Ulrike Bacher
- Department of Hematology, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Aaron T Gerds
- Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Jane L Liesveld
- Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Celalettin Ustun
- Division of Hematology/Oncology/Cell Therapy, Rush University, Chicago, IL, USA
| | - Richard F Olsson
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden.,Centre for Clinical Research Sormland, Uppsala University, Uppsala, Sweden
| | - Andrew Daly
- Tom Baker Cancer Center, Calgary, Alberta, Canada
| | - Michael R Grunwald
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute/Atrium Health, Charlotte, NC, USA
| | - Melhem Solh
- The Blood and Marrow Transplant Group of Georgia, Northside Hospital, Atlanta, GA, USA
| | - Zachariah DeFilipp
- Blood and Marrow Transplant Program, Massachusetts General Hospital, Boston, MA, USA
| | - Mahmoud Aljurf
- Department of Oncology, King Faisal Specialist Hospital Center & Research, Riyadh, Saudi Arabia
| | - Baldeep Wirk
- Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA, USA
| | - Gorgun Akpek
- Stem Cell Transplantation and Cell Therapy, Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Taiga Nishihori
- Department of Blood and Marrow Transplantation, H. Lee Moffitt Cancer and Research Institute, Tampa, FL, USA
| | - Jan Cerny
- Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA, USA
| | - Sachiko Seo
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan
| | - Jack W Hsu
- Division of Hematology & Oncology, Department of Medicine, Shands HealthCare and University of Florida, Gainesville, FL, USA
| | - Richard Champlin
- Department of Stem Cell Transplantation and Cellular Therapy, Division of Cancer Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Marcos de Lima
- Department of Medicine, Seidman Cancer Center, University Hospitals Case Medical Center, Cleveland, OH, USA
| | - Edwin Alyea
- Center of Hematologic Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Uday Popat
- Department of Lymphoma/Myeloma, UT MD Anderson Cancer Center, Houston, TX, USA
| | - Ronald Sobecks
- Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Bart L Scott
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Hagop Kantarjian
- Department of Leukemia, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jorge Cortes
- Department of Leukemia, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.,Division of Hematology/Oncology, Department of Medicine, Georgia Cancer Center at Augusta University, Augusta, GA, USA
| | - Wael Saber
- Department of Medicine, Medical College of Wisconsin, CIBMTR (Center for International Blood and Marrow Transplant Research), Milwaukee, WI, USA
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