Optimizing patient selection for myeloablative allogeneic hematopoietic cell transplantation in chronic myeloid leukemia in chronic phase

Jiří Pavlů, Andrea K. Kew, Beatrice Taylor-Roberts, Holger W. Auner, David Marin, Eduardo Olavarria, Edward J. Kanfer, Donald H. MacDonald, Dragana Milojkovic, Amin Rahemtulla, Katayoun Rezvani, John M. Goldman, Jane F. Apperley, Richard M. Szydlo

Research output: Contribution to journalArticlepeer-review

50 Scopus citations

Abstract

Outstanding results have been obtained in the treatment of chronic myeloid leukemia (CML) with first-line imatinib therapy. However, approximately 35% of patients will not obtain long-term benefit with this approach. Allogeneic hematopoietic stem cell transplantation (HCT) is a valuable second- and third-line therapy for appropriately selected patients. To identify useful prognostic indicators of transplantation outcome in postimatinib therapeutic interventions, we investigated the role of the HCT comorbidity index (HCT-CI) together with levels of C-reactive protein (CRP) before HCT in 271 patients who underwent myeloablative HCT for CML in first chronic phase. Multivariate analysis showed both an HCT-CI score higher than 0 and CRP levels higher than 9 mg/L independently predict inferior survival and increased nonrelapse mortality at 100 days after HCT. CML patients without comorbidities (HCT-CI score 0) with normal CRP levels (0-9 mg/L) may therefore be candidates for early allogeneic HCT after failing imatinib.

Original languageEnglish (US)
Pages (from-to)4018-4020
Number of pages3
JournalBlood
Volume115
Issue number20
DOIs
StatePublished - May 20 2010

ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

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