TY - JOUR
T1 - Maintenance Tyrosine Kinase Inhibitors Following Allogeneic Hematopoietic Stem Cell Transplantation for Chronic Myelogenous Leukemia
T2 - A Center for International Blood and Marrow Transplant Research Study
AU - DeFilipp, Zachariah
AU - Ancheta, Richard
AU - Liu, Ying
AU - Hu, Zhen Huan
AU - Gale, Robert Peter
AU - Snyder, David
AU - Schouten, Harry C.
AU - Kalaycio, Matt
AU - Hildebrandt, Gerhard C.
AU - Ustun, Celalettin
AU - Daly, Andrew
AU - Ganguly, Siddhartha
AU - Inamoto, Yoshihiro
AU - Litzow, Mark
AU - Szer, Jeffrey
AU - Savoie, Mary Lynn
AU - Hossain, Nasheed
AU - Kharfan-Dabaja, Mohamed A.
AU - Hamadani, Mehdi
AU - Reshef, Ran
AU - Bajel, Ashish
AU - Schultz, Kirk R.
AU - Gadalla, Shahinaz
AU - Gerds, Aaron
AU - Liesveld, Jane
AU - Juckett, Mark B.
AU - Kamble, Rammurti
AU - Hashmi, Shahrukh
AU - Abdel-Azim, Hisham
AU - Solh, Melhem
AU - Bacher, Ulrike
AU - Lazarus, Hillard
AU - Olsson, Richard
AU - Cahn, Jean Yves
AU - Grunwald, Michael R.
AU - Savani, Bipin N.
AU - Yared, Jean
AU - Rowe, Jacob M.
AU - Cerny, Jan
AU - Chaudhri, Naeem A.
AU - Aljurf, Mahmoud
AU - Beitinjaneh, Amer
AU - Seo, Sachiko
AU - Nishihori, Taiga
AU - Hsu, Jack W.
AU - Ramanathan, Muthalagu
AU - Alyea, Edwin
AU - Popat, Uday
AU - Sobecks, Ronald
AU - Saber, Wael
N1 - Publisher Copyright:
© 2019 American Society for Transplantation and Cellular Therapy
PY - 2020/3
Y1 - 2020/3
N2 - It remains unknown whether the administration of tyrosine kinase inhibitors (TKIs) targeting BCR-ABL1 after allogeneic hematopoietic cell transplantation (HCT) is associated with improved outcomes for patients with chronic myelogenous leukemia (CML). In this registry study, we analyzed clinical outcomes of 390 adult patients with CML who underwent transplantation between 2007 and 2014 and received maintenance TKI following HCT (n = 89) compared with no TKI maintenance (n = 301), as reported to the Center for International Blood and Marrow Transplant Research. All patients received TKI therapy before HCT. The majority of patients had a disease status of first chronic phase at HCT (n = 240; 62%). The study was conducted as a landmark analysis, excluding patients who died, relapsed, had chronic graft-versus-host disease, or were censored before day +100 following HCT. Of the 89 patients who received TKI maintenance, 77 (87%) received a single TKI and the other 12 (13%) received multiple sequential TKIs. The most common TKIs used for maintenance were dasatinib (n = 50), imatinib (n = 27), and nilotinib (n = 27). As measured from day +100, the adjusted estimates for 5-year relapse (maintenance, 35% versus no maintenance, 26%; P = .11), leukemia-free survival (maintenance, 42% versus no maintenance, 44%; P = .65), or overall survival (maintenance, 61% versus no maintenance, 57%; P = .61) did not differ significantly between patients receiving TKI maintenance or no maintenance. These results remained unchanged in multivariate analysis and were not modified by disease status before transplantation. In conclusion, our data from this day +100 landmark analysis do not demonstrate a significant impact of maintenance TKI therapy on clinical outcomes. The optimal approach to TKI administration in the post-transplantation setting in patients with CML remains undetermined.
AB - It remains unknown whether the administration of tyrosine kinase inhibitors (TKIs) targeting BCR-ABL1 after allogeneic hematopoietic cell transplantation (HCT) is associated with improved outcomes for patients with chronic myelogenous leukemia (CML). In this registry study, we analyzed clinical outcomes of 390 adult patients with CML who underwent transplantation between 2007 and 2014 and received maintenance TKI following HCT (n = 89) compared with no TKI maintenance (n = 301), as reported to the Center for International Blood and Marrow Transplant Research. All patients received TKI therapy before HCT. The majority of patients had a disease status of first chronic phase at HCT (n = 240; 62%). The study was conducted as a landmark analysis, excluding patients who died, relapsed, had chronic graft-versus-host disease, or were censored before day +100 following HCT. Of the 89 patients who received TKI maintenance, 77 (87%) received a single TKI and the other 12 (13%) received multiple sequential TKIs. The most common TKIs used for maintenance were dasatinib (n = 50), imatinib (n = 27), and nilotinib (n = 27). As measured from day +100, the adjusted estimates for 5-year relapse (maintenance, 35% versus no maintenance, 26%; P = .11), leukemia-free survival (maintenance, 42% versus no maintenance, 44%; P = .65), or overall survival (maintenance, 61% versus no maintenance, 57%; P = .61) did not differ significantly between patients receiving TKI maintenance or no maintenance. These results remained unchanged in multivariate analysis and were not modified by disease status before transplantation. In conclusion, our data from this day +100 landmark analysis do not demonstrate a significant impact of maintenance TKI therapy on clinical outcomes. The optimal approach to TKI administration in the post-transplantation setting in patients with CML remains undetermined.
KW - Allogeneic hematopoietic cell transplantation
KW - Chronic myelogenous leukemia
KW - Maintenance
KW - Tyrosine kinase inhibitor
UR - http://www.scopus.com/inward/record.url?scp=85076548681&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85076548681&partnerID=8YFLogxK
U2 - 10.1016/j.bbmt.2019.10.017
DO - 10.1016/j.bbmt.2019.10.017
M3 - Article
C2 - 31669399
AN - SCOPUS:85076548681
SN - 1083-8791
VL - 26
SP - 472
EP - 479
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
IS - 3
ER -
