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Positive Long-Term Outcome Reported for 5-Year Survivors of Allogeneic Hematopoietic Stem Cell Transplantation for Chronic Myelogenous Leukemia: Presented at ASBMT

By Alan McClelland

HONOLULU, HI -- February 21, 2006 -- According to the results of the largest study of patient outcomes in allogeneic hemaotopoietic stem cell transplantation (allo-HSCT) for chronic myelogenous leukemia (CML) ever performed, 87% of patients who survived for 5 years were still alive 15 years after transplantation.

In an analysis of 8738 patients who received donor cell transplantation between 1978 and 1998, 2954 patients were alive and cancer free 5 years post-transplantation.

The Chronic Leukemia Working Committee of the Center for International Blood and Marrow Transplant Research analyzed the long term outcome in these patients. John M. Goldman, MD, Clinical Professor, Division of Investigative Science, Medicine, Imperial College London, London, United Kingdom, presented the results at the 2006 Blood and Marrow Transplant Tandem Meetings (ASBMT) on February 16^th.

The first allo-HSCT procedures for CML were performed in 1978. By the 1980s a large number of these transplants were being done, with the perception by 1990 that patients who had done well in the initial years after transplantation were cured of their disease.

However, in this large study, during the 10 year period of patient follow up, approximately 10% of patients experienced a relapse of their leukemia. The latest relapse occurred 16 years after transplantation, according to Dr. Goldman.

By comparing the relative rate of mortality in the 5 year survivors to controls who were matched for age, sex and race, and nationality, the investigators showed that after 15 years, the death rate for these patients approaches that of the general population, suggesting that there is a declining risk of excess mortality with time.

The investigators identified several factors that predicted an increased risk of death. These include the age of the patient at time of transplant, use of total body irradiation in the conditioning regimen, chronic graft versus host disease (GVHD), transplantation from a female donor to a male recipient.

Of the 227 deaths in the study population, 17% were due to CML disease and 15% to chronic GVHD, with the remainder due to infection, organ failure and other causes.

"We conclude that the majority of remissions after allo-HSCT looked at beyond 5 years are durable, but that there is a low but constant rate of relapse that persists for greater than 15 years," Dr. Goldman said.


[Presentation title: Long-Term Outcome After Allogeneic Hematopoietic Cell Transplantation for CML: Abstract 40]

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