Allogeneic Stem Cell Transplantation for Chronic Myeloid Leukemia in the Era of Tyrosine Kinase Inhibitors- What are the Limitations?

Sehar Afreen

doi:10.4172/2157-2518.s14-001

Abstract

The treatment strategies for chronic myeloid leukemia have changed dramatically with the advent of tyrosine kinase inhibitors. Since they provide an excellent opportunity for complete cytogenetic and molecular remissions, they are recommended as a first line therapy. Although a small fraction of patients has been reported to remain in molecular remissions after discontinuing of tyrosine kinase inhibitors, there is an increased likelihood of disease relapse after these drugs are discontinued. Therefore, allogeneic stem cell transplantation remains the only cure at present. However, toxicity of preparative regimens, development of graft versus host disease, infectious complications, and increased rates of relapse in advanced phases of the disease limit the safety and efficacy of this approach. This review highlights the major limitations of transplantation and the areas of studies required to improve the clinical outcomes.

Highlights

Chronic Myeloid Leukemia (CML) is a hematological malignancy that arises from hematopoietic stem cells with abnormal BCR/ABL gene [1,2,3,4]
Disease Relapse and Donor Lymphocyte Infusions. Another major limitation of allo-Stem Cells Transplantation (SCT) is DR due to which success rate of allo-SCT declines to 20-30% [83,84]. 5-20% of the chronic phase patients relapse following allo-SCT while the rate is as high as 30-60% for the patients who are in advanced phase at the time of transplantation [85]
Allo-SCT still remains the only cure for CML, it is not without significant risks of morbidity and mortality

Summary

Introduction

Chronic Myeloid Leukemia (CML) is a hematological malignancy that arises from hematopoietic stem cells with abnormal BCR/ABL gene [1,2,3,4]. In another study by Kantarjian et al [40] the cumulative rates of complete cytogenetic and molecular remissions at 12 months were significantly higher for the patients receiving dasatinib (46%), compared with imatinib (28%). Talpaz et al [45] reported the response rates of 40 CML-CP, and 44 advanced phase patients with dasatinib after imatinib resistance/intolerance.

Results

Conclusion