Drug treatment is superior to allografting as first-line therapy in chronic myeloid leukemia

Hehlmann, Rüdiger; Berger, Ute; Pfirrmann, Markus; Heimpel, Hermann; Hochhaus, Andreas; Hasford, Joerg; Kolb, Hans-Jochem; Lahaye, Tanja; Maywald, Ole; Reiter, Andreas; Hossfeld, Dieter K; Huber, Christoph; Löffler, Helmut; Pralle, Hans; Queisser, Wolfgang; Tobler, Andreas; Nerl, Christoph; Solenthaler, Max; Goebeler, Mariele E; Griesshammer, Martin; ... (2007). Drug treatment is superior to allografting as first-line therapy in chronic myeloid leukemia. Blood, 109(11), pp. 4686-92. Washington, D.C.: American Society of Hematology 10.1182/blood-2006-11-055186

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Early allogeneic hematopoietic stem cell transplantation (HSCT) has been proposed as primary treatment modality for patients with chronic myeloid leukemia (CML). This concept has been challenged by transplantation mortality and improved drug therapy. In a randomized study, primary HSCT and best available drug treatment (IFN based) were compared in newly diagnosed chronic phase CML patients. Assignment to treatment strategy was by genetic randomization according to availability of a matched related donor. Evaluation followed the intention-to-treat principle. Six hundred and twenty one patients with chronic phase CML were stratified for eligibility for HSCT. Three hundred and fifty four patients (62% male; median age, 40 years; range, 11-59 years) were eligible and randomized. One hundred and thirty five patients (38%) had a matched related donor, of whom 123 (91%) received a transplant within a median of 10 months (range, 2-106 months) from diagnosis. Two hundred and nineteen patients (62%) had no related donor and received best available drug treatment. With an observation time up to 11.2 years (median, 8.9 years), survival was superior for patients with drug treatment (P = .049), superiority being most pronounced in low-risk patients (P = .032). The general recommendation of HSCT as first-line treatment option in chronic phase CML can no longer be maintained. It should be replaced by a trial with modern drug treatment first.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Haematology and Central Haematological Laboratory
UniBE Contributor:	Tobler, Andreas (B), Solenthaler, Max
ISSN:	0006-4971
ISBN:	17317858
Publisher:	American Society of Hematology
Language:	English
Submitter:	Factscience Import
Date Deposited:	04 Oct 2013 14:54
Last Modified:	29 Mar 2023 23:32
Publisher DOI:	10.1182/blood-2006-11-055186
PubMed ID:	17317858
Web of Science ID:	000246946100021
URI:	https://boris.unibe.ch/id/eprint/22908 (FactScience: 37635)