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Imatinib mesylate versus allogeneic hematopoietic stem cell transplantation for patients with chronic myelogenous leukemia in accelerated phase.
MedLine Citation:
PMID:  21252092     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
The relative merits of allogeneic hematopoietic stem cell transplantation (allo-HSCT) and imatinib for chronic myelogenous leukemia (CML) in accelerated phase (AP) have not previously been evaluated. This cohort study was designed to compare the outcomes of imatinib (n=87) versus allo-HSCT (n=45) for AP CML. A multivariate analysis of the total population revealed that CML duration > 12 months, hemoglobin < 100 g/L and peripheral blood blasts > 5% were independent adverse prognostic factors for both overall survival (OS) and progression-free survival (PFS). Both treatments resulted in similar survival in low-risk (no factor) patients, with six-year event-free survival (EFS), OS and PFS rates of more than 80.0%. Intermediate-risk (any factor) patients showed no difference in EFS and OS, but six-year PFS rates were 55.7% vs. 92.9% (P=0.047) with imatinib versus allo-HSCT. Among high-risk (at least two factors) patients, imatinib was by far inferior to allo-HSCT, with five-year EFS, OS and PFS rates of 9.3% vs. 66.7% (P=0.034), 17.7% vs. 100% (P=0.008) and 18.8% vs. 100% (P=0.006), respectively. We conclude that allo-HSCT, compared to imatinib, confers significant survival advantages for high- and intermediate-risk patients with AP CML; however, the outcomes of the two therapies are equally good in low-risk patients. All trials were registered with www.chictr.org as CHiCHTR-TNC-10000955.
Authors:
Qian Jiang; Lan-Ping Xu; Dai-Hong Liu; Kai-Yan Liu; Shan-Shan Chen; Bin Jiang; Hao Jiang; Huan Chen; Yu-Hong Chen; Wei Han; Xiao-Hui Zhang; Yu Wang; Ya-Zhen Qin; Yan-Rong Liu; Yue-Yun Lai; Xiao-Jun Huang
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-1-20
Journal Detail:
Title:  Blood     Volume:  -     ISSN:  1528-0020     ISO Abbreviation:  -     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-1-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7603509     Medline TA:  Blood     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China.
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