Outcomes of Patients with Chronic Myeloid Leukemia Who Underwent Allogeneic Stem Cell Transplantation in the Tyrosine Kinase Inhibitors Era

• Published in: Blood 2024-11, Vol.144 (Supplement 1), p.7396-7396
• Main Authors: Wernicke, German Jose, Enrico, Alicia I, Cattaneo, Maximiliano, Bendek Del Prete, Georgina Emilia, Pelayes Tortosa, Sofia, De Luca, Teofilo, Bentolila, Gonzalo, Castro, Martin, Castellanos, Leandro Roberto, Saslavsky, Martin, Rivas, María Marta, Vitriu, Adriana, Arbelbide, Jorge Alberto, Perez, Mariel Ana, Berro, Mariano, Basquiera, Ana Lisa
• Format: Article
• Language: English
• ISSN: 0006-4971; 1528-0020
• DOI: 10.1182/blood-2024-209075

Introduction: Since the introduction of tyrosine kinase inhibitors (TKI) agents, the role of allogeneic stem cell transplantation (Allo-SCT) is limited to patients with insufficient TKI response/TKI intolerance in the first chronic phase or those who developed a blast phase (BP). Objective: We aimed to evaluate the results of Allo-SCT in patients with CML in the TKI era. Methods: A retrospective study of patients who underwent Allo-SCT was conducted in Argentina between 2010 and 2023 in centers affiliated to GATMO-TC (Grupo Argentino de Trasplante de Médula Ósea y Terapia Celular). Outcomes evaluated were: overall survival (OS), progression free survival (PFS), non-relapse mortality (NRM) and relapse incidence (RI), and incidence of acute and chronic graft versus host disease (GVHD). Results: Data of 80 patients were analyzed (median age at transplant 42 years; range 17-69; 64% males). Median time from diagnosis to transplant was 31 months (range 1-252) and median number of TKI received before transplant was 2 (range 1-5). (91% imatinib, 88% dasatinib, 46% nilotinib, 23% ponatinib and 1% bosutinib). Indications for transplantation were: no-BP (insufficient TKI response, 26%; TKI toxicity 9%; and accelerated phase, 9%) and BP (55%). A total of 13% had a T315 mutation. Donors were: 67% matched, 12% mismatched unrelated, and 20% familiar haploidentical. Absence of any molecular response was reported in 39%. Most of the patients received a myeloablative conditioning regimen (79%) and only 4 patients (5%) had a high HCT-CI. After a median follow-up of 57 months, 5-year OS was 51% (95% CI 38-62). Inferior OS was observed in patients undergoing Allo-SCT after BP (35%; 95%CI 28-50), vs non-BP (72%;95% 52-85); p