Soyer N, Uysal A, Tombuloglu M, Sahin F, Saydam G, Vural F. Allogeneic stem cell transplantation in chronic myeloid leukemia patients: Single center experience. World J Hematol 2017; 6(1): 1-10 [DOI: 10.5315/wjh.v6.i1.1]
Corresponding Author of This Article
Nur Soyer, MD, Department of Hematology, Ege University Medical Faculty, Ankara Blvd, Bornova, 35100 Izmir, Turkey. drakadnur@yahoo.com
Research Domain of This Article
Hematology
Article-Type of This Article
Frontier
Open-Access Policy of This Article
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0.666 when age ≥ 50 + (0.042 × spleen) + 1.0956 when platelet > 1500 × 109/L + (0.0584 × blast cells) + 0.20399 when basophils > 3% + (0.0413 × eosinophils) + 100
Spleen × 4 + basophils × 7
Risk definition
Exponential of the total
Total × 1000
Total
Low risk: < 0.8
Low risk: ≤ 780
Low risk: ≤ 87
Intermediate risk: 0.8-1.2
Intermediate risk: 781-1480
High risk: > 87
High risk: > 1.2
High risk: > 1480
Table 2 European LeukemiaNet response criteria to tyrosine kinase inhibitors at first line
Optimal
Warning
Failure
Baseline
NA
High risk or CCA/Ph+, major route
NA
3 mo
BCR-ABL1 ≤ 10% and/or Ph+ ≤ 35%
BCR-ABL1 > 10% and/or Ph+ 35%-95%
Non-CHR and/or Ph+ > 95%
6 mo
BCR-ABL1 ≤ 1% and/or Ph+ 0
BCR-ABL1 1%-10% and/or Ph+ 1%-35%
BCR-ABL1 > 10% and/or Ph+ > 35%
12 mo
BCR-ABL1 ≤ 0.1%
BCR-ABL1 > 0.1%-1%
BCR-ABL1 > 1% and/or Ph+ > 0
Then, and any at time
BCR-ABL1 ≤ 0.1%
CCA/Ph- (-7 or 7q-)
Loss of CHR Loss of CCyR Confirmed loss of MMR mutations CCA/Ph+
Table 3 Patients characteristics
Patient
Sex
Age at ASCT (yr)
Disease phase at ASCT
Time from diagnosis to ASCT (mo)
Indication for ASCT
Donor sex
1
M
22
1st AP
50
Resistance to imatinib and clonal evolution
M
2
F
51
2nd CP
14
Previous myeloid blastic phase
M
3
M
25
2nd CP
61
Previous lymphoid blastic phase
M
4
M
33
1st CP
37
Resistance to imatinib and dasatinib
M
5
F
54
1st AP
103
Resistance to imatinib, nilotinib and dasatinib 1st accelerated phase
F
6
M
65
1st CP
133
Resistance to imatinib and nilotinib
F
7
F
49
1st CP
62
Resistance to imatinib
M
8
M
53
2nd CP
63
Previous myeloid blastic phase
M
9
M
41
1st CP
51
Resistance to imatinib
M
10
M
61
1st CP
75
Resistance to imatinib, nilotinib and dasatinib
F
Table 4 Transplantation outcomes
Patient
PNL engraftment (d)
PLT engraftment (d)
Acute GVHD
Chronic GVHD
Post-transplant disease status
Last status
1
12
18
No
No
Molecular relapse and granulocytic sarcoma
Died
2
15
16
No
No
Blastic crises
Died
3
18
30
No
No
Remission
Died
4
14
14
Yes
No
Remission
Died
5
25
21
Yes
Yes
Remission
Alive
6
19
15
Yes
No
Remission
Died
7
10
10
No
No
Remission
Alive
8
10
10
Yes
No
Remission
Died
9
11
14
Yes
No
Remission
Alive
10
12
13
Yes
No
Remission
Died
Citation: Soyer N, Uysal A, Tombuloglu M, Sahin F, Saydam G, Vural F. Allogeneic stem cell transplantation in chronic myeloid leukemia patients: Single center experience. World J Hematol 2017; 6(1): 1-10