Role of Allogeneic Stem Cell Transplantation for Adult Chronic Myeloid Leukemia in the Imatinib Era

Survival after HLA-identical sibling myeloablative transplantations (n = 1373) for CML-CP1 between 2000 and 2005, with a median follow-up of 18 months (range, <1-70). These data are preliminary and were obtained from the Statistical Center of the CIBMTR (permission granted by Mary Horowitz, MD). These are compared with survival using imatinib from the IRIS trial; 553 patients were recruited in 2000-2001, with data analyzed in July 2004, a median follow-up of 42 months [28]. Probabilities of survival at 1, 3, and 5 years were 81 ± 1%, 74 ± 2%, and 73 ± 2%, respectively, after transplantation. Probabilities of survival at 1.5, 2, and 3.5 years after imatinib were 97.2%, 96 ± 2%, and 91%, respectively. BMT indicates bone marrow transplantation.

Suggested monitoring and treatment algorithm for patients with newly diagnosed CML-CP1 receiving imatinib. QPCR indicates quantitative polymerase chain reaction.

Suggested approach to suboptimal response to imatinib 400 mg/d in the absence of mutational analysis. CHR indicates complete hematologic response; MCR, major cytogenetic response (Ph⁻ >65%); CCR, complete cytogenetic response; MMR, major molecular response (>3 log reduction in BCR-ABL).