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Type: Journal article
Title: Clinical and biological predictors of outcome following relapse of CML post-allo-SCT
Author: Jain, N.
Ito, S.
Tian, X.
Kurlander, R.
Battiwalla, M.
Lu, K.
Savani, B.
Malkovska, V.
Rezvani, K.
Le, R.
Shenoy, A.
Hourigan, C.
Keyvanfar, K.
Koklanaris, E.
Superata, J.
Muranski, P.
Barrett, A.
Yong, A.
Citation: Bone Marrow Transplantation, 2014; 50(2):189-196
Publisher: Nature Publishing Group
Issue Date: 2014
ISSN: 0268-3369
Statement of
NA Jain, S Ito, X Tian, R Kurlander, M Battiwalla, K Lu, BN Savani, V Malkovska, K Rezvani, RQ Le, A Shenoy, CS Hourigan, K Keyvanfar, E Koklanaris, J Superata, P Muranski, AJ Barrett, and ASM Yong
Abstract: Although there are now fewer allo-SCTs performed for CML, leukemic relapse post transplant remains a persistent problem. To better define clinical and biological parameters determining postrelapse outcome, we studied 59 patients with CML relapsing after HLA-identical sibling allo-SCT between 1993 and 2008. Eighteen (30.5%) were transplanted in advanced phase and 41 (69.5%) in chronic phase. With a median follow-up from relapse of 7.9 years, 5-year post relapse survival (PRS) was 62%. Multivariate analysis found disease status at transplant, time to diagnosis of relapse from transplant and pretransplant tyrosine kinase inhibitor (TKI) use as significant factors associated with PRS. Analysis of BCR-ABL transcript expression in the hematopoietic progenitor compartment was performed in 36 patients (22 relapsed, 8 non-relapsed and 6 TKI alone controls). Patients with BCR-ABL expression in their early hematopoietic stem cell compartment (Lineage−CD34+CD38−CD90+) had worse survival irrespective of the disease status. We conclude that disease status remains the strongest clinical prognostic factor for PRS in CML following allo-SCT. The persistence of BCR-ABL expression in the progenitor cell compartment in some patients after SCT emphasizes the need to target CML-leukemia stem cells.
Keywords: Humans; Recurrence; Disease-Free Survival; Hematopoietic Stem Cell Transplantation; Survival Rate; Retrospective Studies; Follow-Up Studies; Adult; Middle Aged; Female; Male; Leukemia, Myelogenous, Chronic, BCR-ABL Positive; Allografts
Rights: © 2015 Macmillan Publishers Limited All rights reserved
RMID: 0030021378
DOI: 10.1038/bmt.2014.249
Appears in Collections:Medicine publications

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