Stem Cell Transplantation for Chronic Myeloid Leukemia (CML): Current Indications and Perspectives
The introduction of tyrosine kinase inhibitors (TKIs) has reduced the indications for allogeneic stem cell
transplants (SCT) in patients with chronic myeloid leukemia (CML) from 1500/year in 2000 to approximately 500/year in
2010. The recently updated indications by the European Leukemia Network include advanced-phase CML and nonresponders
to second-line TKIs. Changes in transplant programs, over the past decade, have resulted in a significant
reduction in transplant related mortality and this has expanded the transplant option to older patients, who may be eligible
for SCT. Transplantation for blastic phase CML remains a challenge due to the high rate of post-transplant relapses. Thus,
in view of this issue, several studies of TKIs after allogeneic SCT have been undertaken with encouraging results. In
conclusion, allogeneic SCT remains a therapeutic option for selected patients with CML and is currently being integrated
with the use of TKIs both before and after transplantation.
Keywords: allogeneic stem cell transplantation, cost-effectiveness, chronic myeloid leukemia, cure, treatment-related
mortality, tyrosine kinase inhibitors.
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