Does early stem-cell transplantation have a role in chronic myeloid leukaemia?

Abstract

Allogeneic haemopoietic stem-cell transplantation (HSCT) can induce long-lasting complete molecular remissions in most patients with chronic myeloid leukemia (CML) for more than 20 years. No other intervention for this disease has such a track record, and early HSCT, despite its associated morbidity and mortality, has become standard care for patients with a compatible donor. This situation has changed with the introduction of the specific tyrosine kinase inhibitor imatinib. The excellent short-term results of imatinib have changed attitudes, and the number of transplantations for CML have declined rapidly since 1999. In this debate, Alois Gratwohl and Gianantonio Rosti present opposing arguments as to whether there is still a role for early HSCT in CML.