Publication details

Long-term outcome of patients with newly diagnosed chronic myeloid leukemia - A randomized comparison of stem cell transplantation with drug treatment

Authors	GRATWOHL Alois PFIRRMANN Markus ZANDER Axel KRÖGER Nicolaus BEELEN Dietrich NOVOTNY Jürgen NERL Christoph SCHEID Christof SPIEKERMANN Karsten MAYER Jiří SAYER Herbert G FALGE Christiane BUNJES Donald DÖHNER Hartmut GANSER Arnold SCHMIDT-WOLF Ingo SCHWERDTFEGER Rainer BAURMANN Herrad KUSE Rolf SCHMITZ Norbert WEHMEIER Artur FISCHER Jörg Th. HO Anthony D. WILHELM Martin GOEBELER Maria-Elisabeth LINDEMANN Hans W. BORMANN Matthias HERTENSTEIN Bernd SCHLIMOK Günter BAERLOCHER Gabriela M. AUL Carlo PFREUNDSCHUH Michael FABIAN Matthias STAIB Peter EDINGER Matthias SCHATZ Michael FAUSER Axel ARNOLD Renate KINDLER Thomas WULF Gerald ROSSELET Anne HELLMANN Andrzej SCHÄFER Erhardt PRÜMMER Otto SCHENK Michael HASFORD Joerg HEIMPEL Herrmann HOSSFELD Dieter K. KOLB Hans-Jochem BÜSCHE Guntram HAFERLACH Claudia SCHNITTGER Susanne MÜLLER Martin C REITER Andreas BERGER Ute SAUßELE Susanne HOCHHAUS Andreas HEHLMANN Rüdiger
Year of publication	2016
Type	Article in Periodical
Magazine / Source	Leukemia
MU Faculty or unit	Faculty of Medicine
Citation
Doi	http://dx.doi.org/10.1038/leu.2015.281
Field	Oncology and hematology
Keywords	CHRONIC MYELOGENOUS LEUKEMIA; BONE-MARROW-TRANSPLANTATION; EUROPEAN LEUKEMIANET; MOLECULAR RESPONSE; HEMATOPOIETIC SCT; INTERFERON-ALPHA; DOSE IMATINIB; SURVIVAL; ERA; RECOMMENDATIONS
Attached files	EL_1316953.pdf
Description	Tyrosine kinase inhibitors represent today’s treatment of choice in chronic myeloid leukemia (CML). Allogeneic hematopoietic stem cell transplantation (HSCT) is regarded as salvage therapy. This prospective randomized CML-study IIIA recruited 669 patients with newly diagnosed CML between July 1997 and January 2004 from 143 centers. Of these, 427 patients were considered eligible for HSCT and were randomized by availability of a matched family donor between primary HSCT (group A; N=166 patients) and best available drug treatment (group B; N=261). Primary endpoint was long-term survival. Survival probabilities were not different between groups A and B (10-year survival: 0.76 [95% CI: 0.69-0.82] vs 0.69 [95% CI: 0.61-0.76]), but influenced by disease and transplant risk. Patients with a low transplant risk showed superior survival compared to patients with high (P<.001) and nonhigh risk disease (P=.047) in group B; after entering blast crisis, survival was not different with or without HSCT. Significantly more patients in group A were in molecular remission (56% vs 39%; P=.005) and free of drug treatment (56% vs 6%; P<.001). Differences in symptoms and Karnofsky score were not significant. In the era of tyrosine kinase inhibitors, HSCT remains a valid option when both disease and transplant risk are considered.