Outcomes and toxicity of allogeneic hematopoietic cell transplantation in chronic myeloid leukemia patients previously treated with second-generation tyrosine kinase inhibitors: a prospective non-interventional study from the Chronic Malignancy Working Party of the EBMT

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  • Stavroula Masouridi-Levrat
  • Eduardo Olavarria
  • Simona Iacobelli
  • Mahmoud Aljurf
  • Elena Morozova
  • Riitta Niittyvuopio
  • Peter Reményi
  • Grzegorz Helbig
  • Paul Browne
  • Arnold Ganser
  • Arnon Nagler
  • John A. Snowden
  • Marie Robin
  • Jakob Passweg
  • Gwendolyn Van Gorkom
  • Hélène Labussière Wallet
  • Jennifer Hoek
  • Henric Jan Blok
  • Theo De Witte
  • Nicolaus Kroeger
  • Patrick Hayden
  • Yves Chalandon
  • Ibrahim Yakoub Agha

Allogeneic hematopoietic cell transplantation (allo-HCT) remains a treatment option for patients with chronic myeloid leukemia (CML) who fail to respond to tyrosine kinase inhibitors (TKIs). While imatinib seems to have no adverse impact on outcomes after transplant, little is known on the effects of prior use of second-generation TKI (2GTKI). We present the results of a prospective non-interventional study performed by the EBMT on 383 consecutive CML patients previously treated with dasatinib or nilotinib undergoing allo-HCT from 2009 to 2013. The median age was 45 years (18–68). Disease status at transplant was CP1 in 139 patients (38%), AP or >CP1 in 163 (45%), and BC in 59 (16%). The choice of 2GTKI was: 40% dasatinib, 17% nilotinib, and 43% a sequential treatment of dasatinib and nilotinib with or without bosutinib/ponatinib. With a median follow-up of 37 months (1–77), 8% of patients developed either primary or secondary graft failure, 34% acute and 60% chronic GvHD. There were no differences in post-transplant complications between the three different 2GTKI subgroups. Non-relapse mortality was 18% and 24% at 12 months and at 5 years, respectively. Relapse incidence was 36%, overall survival 56% and relapse-free survival 40% at 5 years. No differences in post-transplant outcomes were found between the three different 2GTKI subgroups. This prospective study demonstrates the feasibility of allo-HCT in patients previously treated with 2GTKI with a post-transplant complications rate comparable to that of TKI-naive or imatinib-treated patients.

OriginalsprogEngelsk
TidsskriftBone Marrow Transplantation
Vol/bind57
Udgave nummer1
Sider (fra-til)23-30
Antal sider8
ISSN0268-3369
DOI
StatusUdgivet - 2022

Bibliografisk note

Funding Information:
This study was supported by Novartis (Novartis study code: CAMN107AGB02T). This study was partially presented as oral abstract at ASH congress in 2016 Blood 2016;128 (22):628.

Funding Information:
YC: Novartis, BMS, Pfizer, Incyte: advisory board; Novartis, BMS: travel grant. IYA: received honoraria from Novartis. JAS: none directly related to this project but otherwise received speaker fees; Jazz, Mallinckrodt, Janssen, Gilead; advisory board; Medac, and clinical trial IDMC membership; Kiadis. The remaining authors declare no competing interests.

Publisher Copyright:
© 2021, The Author(s).

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