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Allogeneic stem cell transplantation for chronic myeloid leukemia in the TKI era: population-based data from the Swedish CML registry
Skane Univ Hosp, Dept Hematol Oncol & Radiat Phys, Lund, Sweden.
Linkoping Univ Hosp, Dept Hematol, Linkoping, Sweden.
Uppsala Univ Hosp, Reg Canc Ctr, Uppsala, Sweden.
Umea Univ Hosp, Dept Hematol, Umea, Sweden.
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2019 (English)In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 54, no 11, p. 1764-1774Article in journal (Refereed) Published
Abstract [en]

Two decades after the introduction of tyrosine kinase inhibitors (TKI), a sizeable portion of patients with chronic myeloid leukemia (CML) in chronic phase (CP) still undergo allogeneic stem cell transplantation (allo-HSCT). We investigated the indications for allo-HSCT, clinical outcome, management of relapse, and post-transplant TKI treatment in a population-based setting using the Swedish CML registry. Of 118 CML patients transplanted between 2002 and 2017, 56 (47.4%) received allo-HSCT in first CP, among whom TM resistance was the most common transplant indication (62.5%). For patients diagnosed with CML in CP at <65 years of age, the cumulative probability of undergoing allo-HSCT within 5 years was 9.7%. Overall 5-year survival was 96.2%, 70.1% and 36.9% when transplanted in first CP, second or later CP, and in accelerated phase or blast crisis, respectively. Risk factors for relapse were EBMT score >2 and reduced intensity conditioning, and for death, CP > 2 at time point of allo-HSCT only. Non-relapse mortality for patients transplanted in CP was 11.6%. Our data indicate that allo-HSCT still constitutes a reasonable therapeutic option for patients with CML in first CP, especially those resistant to TKI treatment, providing high long-term survival and low non-relapse mortality.

Place, publisher, year, edition, pages
2019. Vol. 54, no 11, p. 1764-1774
National Category
Hematology
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URN: urn:nbn:se:uu:diva-397685DOI: 10.1038/s41409-019-0513-5ISI: 000495103300009PubMedID: 30962502OAI: oai:DiVA.org:uu-397685DiVA, id: diva2:1373856
Available from: 2019-11-28 Created: 2019-11-28 Last updated: 2019-11-28Bibliographically approved

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Höglund, MartinOlsson-Strömberg, Ulla

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