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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, Sweden.
Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Haematology.
Uppsala Univ Hosp, Sweden.
Umea Univ Hosp, 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 amp;lt;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 amp;gt;2 and reduced intensity conditioning, and for death, CP amp;gt; 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
NATURE PUBLISHING GROUP , 2019. Vol. 54, no 11, p. 1764-1774
National Category
Hematology
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URN: urn:nbn:se:liu:diva-162333DOI: 10.1038/s41409-019-0513-5ISI: 000495103300009PubMedID: 30962502OAI: oai:DiVA.org:liu-162333DiVA, id: diva2:1374071
Available from: 2019-11-28 Created: 2019-11-28 Last updated: 2019-11-28

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Dreimane, Arta
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Department of Clinical and Experimental MedicineFaculty of Medicine and Health SciencesDepartment of Haematology
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