The early referral for reduced-intensity stem cell transplantation in patients with ph1 (+) chronic myelogenous leukemia in chronic phase in the imatinib era: Results of the Latin American Cooperative Oncohematology Group (LACOHG) prospective, multicenter study

Abstract

Using a reduced-intensity stem cell transplantation (RIST) schedule, 24 patients with Philadelphia (Ph1) (+) chronic myelogenous leukemia (CML) in first chronic phase (CP) were prospectively allografted in four Latin American countries: Mexico, Brazil, Colombia and Venezuela, using HLA-identical siblings as donors. The median age of the patients was 41 years (range 10–71 years); there were eight females. Patients received a median of 4.4 × 106/kg CD34 cells. The median time to achieve above 0.5 × 109/l granulocytes was 12 days, range 0–41 days, and the median time to achieve above 20 × 109/l platelets was also 12 days, range 0–45 days. In all, 22 patients are alive 81–830 (median 497) days after RIST. The 830-day probability of survival is 92%, and the median survival has not been reached, being beyond 830 days. A total of 11 patients (46%) developed acute graft-versus-host disease (GVHD), and seven of 23 (30%) developed chronic GVHD. Two patients died 43 and 210 days after RIST, one as a result of sepsis and the other of chronic GVHD. The 100-day mortality was 4.4%, and transplant-related mortality was 8%. RIST for patients with CML in CP appears to be an adequate therapeutic option.