Bone Marrow Transplantation for Chronic Myelogenous Leukemia in Chronic Phase

TLDR

The study analyzed data from 405 chronic phase CML patients undergoing bone marrow transplantation to identify outcome predictors. Four‑year relapse and survival rates were 19 % and 55 %, respectively, and relapse was markedly higher with T‑cell‑depleted grafts (RR 5.4) and absence of chronic GVHD (RR 3.1), while survival was lower with moderate‑to‑severe acute GVHD (RR 3.7.

Abstract

Data on 405 patients with chronic myelogenous leukemia who received bone marrow transplants in chronic phase were analyzed for factors predictive of outcome. The 4-year actuarial probability of relapse was 19% (95% confidence interval [Cl], 12% to 28% ) and of survival, 55% (95% Cl, 50% to 60%). In multivariate analyses the probability of relapse was higher for recipients of T-cell-depleted bone marrow compared with recipients of non-T-cell-depleted bone marrow (relative risk, 5.4; P < 0.0001) and for patients who did not develop chronic graft-versus-host disease with patients who did (relative risk, 3.1; P < 0.01). The probability of survival was lower for patients who developed moderate to severe acute graft-versus-host disease than for patients with no or mild acute graft-versus-host disease (relative risk, 3.7; P < 0.0001), and in patients aged 20 or older than in younger patients (relative risk, 2.6; P < 0.0002). Duration of disease before transplant was not associated with outcome. Bone marrow transplantation done in the chronic phase of chronic myelogenous leukemia offers some patients prolonged leukemia-free survival. The Tcell-depleted grafts are associated with an increased probability of relapse.