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

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Serval ID
serval:BIB_E928980A6C80
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Long-term outcome of patients with newly diagnosed chronic myeloid leukemia: a randomized comparison of stem cell transplantation with drug treatment.
Journal
Leukemia
Author(s)
Gratwohl A., Pfirrmann M., Zander A., Kröger N., Beelen D., Novotny J., Nerl C., Scheid C., Spiekermann K., Mayer J., Sayer H.G., Falge C., Bunjes D., Döhner H., Ganser A., Schmidt-Wolf I., Schwerdtfeger R., Baurmann H., Kuse R., Schmitz N., Wehmeier A., Th Fischer J., Ho A.D., Wilhelm M., Goebeler M.E., Lindemann H.W., Bormann M., Hertenstein B., Schlimok G., Baerlocher G.M., Aul C., Pfreundschuh M., Fabian M., Staib P., Edinger M., Schatz M., Fauser A., Arnold R., Kindler T., Wulf G., Rosselet A., Hellmann A., Schäfer E., Prümmer O., Schenk M., Hasford J., Heimpel H., Hossfeld D.K., Kolb H.J., Büsche G., Haferlach C., Schnittger S., Müller M.C., Reiter A., Berger U., Saußele S., Hochhaus A., Hehlmann R.
ISSN
1476-5551 (Electronic)
ISSN-L
0887-6924
Publication state
Published
Issued date
2016
Peer-reviewed
Oui
Volume
30
Number
3
Pages
562-569
Language
english
Abstract
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 end point was long-term survival. Survival probabilities were not different between groups A and B (10-year survival: 0.76 (95% confidence interval (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 with patients with high- (P<0.001) and non-high-risk disease (P=0.047) 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=0.005) and free of drug treatment (56% vs 6%; P<0.001). 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.
Pubmed
Web of science
Open Access
Yes
Create date
05/04/2016 16:57
Last modification date
20/08/2019 16:11
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