Risk assessment in patients with Ph+ chronic myelogenous leukemia at first relapse after allogeneic stem cell transplant: An EBMT retrospective analysis

Cesare Guglielmi, William Arcese, Jo Hermans, Andrea Bacigalupo, Giuseppe Bandini, Donald Bunjes, Enric Carreras, Agnès Devergie, Francesco Frassoni, John Goldman, Alois Gratwohl, Hans Jochem Kolb, Anna P. Iori, Dietger Niederwieser, H. Grant Prentice, Theo De Witte, Jane Apperley

Research output: Contribution to journalArticle

Abstract

Patients with Ph+ chronic myelogenous leukemia who relapse after a first allogeneic stem cell transplant still have a possibility of long-term survival. To assess the value of the individual therapeutic options, the factors predicting outcome should be identified. We investigated data from 500 patients who relapsed before July 1996; follow-up was updated during 1998. The actuarial survival from relapse was 34.2% (95% confidence interval [Cl]: 29.9%-38.5%) at 5 years and 23.4% (95% Cl: 18.9%-27.9%) at 10 years. Survival after relapse was significantly related to 5 factors: time from diagnosis to transplant (<2 years vs ≥ 2 years), disease phase at transplant (first chronic phase vs other), disease stage at relapse (cytogenetic or chronic phase vs advanced phase), time from transplant to relapse (<1 year vs ≥ 1 year), and donor type (HLA-identical sibling vs volunteer unrelated donor). The effects of individual adverse risk factors were cumulative: The probability of survival at 10 years decreased stepwise from 42% (0 factors), 32% (1 factor), 14% (2 factors), 3% (3 factors), to 0% (4 or 5 factors). Novel strategies for high-risk patients are warranted. We conclude that these 5 factors should be taken into account when comparing results of salvage therapies in patients with Ph-t- chronic myeloid leukemia relapsing after allogeneic stem cell transplant. (C) 2000 by The American Society of Hematology.

Original languageEnglish
Pages (from-to)3328-3334
Number of pages7
JournalBlood
Volume95
Issue number11
Publication statusPublished - Jun 1 2000

ASJC Scopus subject areas

  • Hematology

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    Guglielmi, C., Arcese, W., Hermans, J., Bacigalupo, A., Bandini, G., Bunjes, D., Carreras, E., Devergie, A., Frassoni, F., Goldman, J., Gratwohl, A., Kolb, H. J., Iori, A. P., Niederwieser, D., Prentice, H. G., De Witte, T., & Apperley, J. (2000). Risk assessment in patients with Ph+ chronic myelogenous leukemia at first relapse after allogeneic stem cell transplant: An EBMT retrospective analysis. Blood, 95(11), 3328-3334.