Journal
BLOOD
Volume 112, Issue 8, Pages 3500-3507Publisher
AMER SOC HEMATOLOGY
DOI: 10.1182/blood-2008-02-141689
Keywords
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Categories
Funding
- Novartis
- National Cancer Institute [U24CA76518]
- National Institute of Allergy and Infectious Diseases
- National Heart, Lung, and Blood Institute
- Office of Naval Research
- Health Resources and Services Administration
- AABB
- Aetna
- American International Group
- American Society for Blood and Marrow Transplantation
- Amgen
- Anonymous donation to the Medical College of Wisconsin
- Astellas Pharma US
- Baxter International
- Bayer HealthCare Pharmaceuticals
- BioOne Corporation
- BloodCenter of Wisconsin
- Blue Cross and Blue Shield Association
- Bone Marrow Foundation
- Bristol-Myers Squibb Company
- Cangene Corporation
- Celgene Corporation
- CellGenix
- Cerus Corporation
- Cubist Pharmaceuticals
- Cylex
- CytoTherm
- DOR BioPharma
- Dynal Biotech, an Invitrogen company
- EKR Therapeutics
- Enzon Pharmaceuticals
- Gambro BCT
- Gamida Cell
- Genzyme Corporation
- Gift of Life Bone Marrow Foundation
- GlaxoSmithKline
- Histogenetics
- HKS Medical Information Systems
- Hospira
- Infectious Diseases Society of America
- Kiadis Pharma
- Kirin Brewery
- Merck Company
- Medical College of Wisconsin
- MGI Pharma
- Millennium Pharmaceuticals
- Miller Pharmacal Group
- Milliman USA
- Miltenyi Biotec
- MultiPlan
- National Marrow Donor Program
- Nature Publishing Group
- Oncology Nursing Society
- Osiris Therapeutics
- Pall Life Sciences
- PDL BioPharma
- Pfizer
- Pharmion Corporation
- Roche Laboratories
- Schering Plough Corporation
- Society for Healthcare Epidemiology of America
- StemCyte
- StemSoft Software
- SuperGen
- Sysmex
- Teva Pharmaceutical Industries
- Marrow Foundation
- THERAKOS
- University of Colorado Cord Blood Bank
- ViaCell
- Vidacare Corporation
- ViraCor Laboratories
- ViroPharma
- Wellpoint
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Imatinib mesylate (IM, Gleevec) has largely supplanted allogeneic hematopoietic cell transplantation (HCT) as first line therapy for chronic myeloid leukemia (CML). Nevertheless, many people with CML eventually undergo HCT, raising the question of whether prior IM therapy impacts HCT success. Data from the Center for International Blood and Marrow Transplant Research on 409 subjects treated with IM before HCT (IM+) and 900 subjects who did not receive IM before HCT (IM-) were analyzed. Among patients in first chronic phase, IM therapy before HCT was associated with better survival but no statistically significant differences in treatment-related mortality, relapse, and leukemia-free survival. Better HLA-matched donors, use of bone marrow, and transplantation within one year of diagnosis were also associated with better survival. A matched-pairs analysis was performed and confirmed a higher survival rate among first chronic phase patients receiving IM. Among patients transplanted with advanced CML, use of IM before HCT was not associated with treatment-related mortality, relapse, leukemia-free survival, or survival. Acute graft-versus-host disease rates were similar between IM+ and IM- groups regardless of leukemia phase. These results should be reassuring to patients receiving IM before HCT.
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