23 September 2020
Leukaemia treatment options evaluated
Published online 2 April 2012
Hematopoietic cell transplantation (HCT) is a treatment chronic myelogenous leukaemia (CML), a cancer of white blood cells. Tyrosine kinase inhibitors (TKI) first came into use in 2001 and recent favorable research on their inhibition of CML progression has expanded the therapeutic options open to patients.
An international team of researchers, including Mahmoud Aljurf of King Faisal Specialist Hospital & Research Center in Riyadh, reviewed 306 CML patients aged 40 and older who have undergone HCT between the years 2001 and 2007, and publish their findings in the journal Blood. This is the time when imatinib, a TKI, came into clinical use. Only patients who have undergone reduced intensity (RIC) or non-myeloablative (NMA) conditioning prior to HCT were included.
The rearchers found that increasing the intensity of conditioning prior to undergoing HCT yields lower risks of relapse and higher disease-free survival rates, with RIC yielding superior results to NMA. Older patients had poorer results, but the data analysis suggests this was owing to them having more advanced stages of CML, rather than their older age. HCT was shown to be safe for older patients, with females showing lower risks.
The study suggests that HCT would be the best therapeutic option for older patients who have developed TKI-resistance, since it can control relapse and has good survival outcomes with moderate toxicity.
- Warlick, E. et al. RIC is superior to NMA conditioning for older Chronic Myelogenous Leukemia patients undergoing Hematopoietic Cell Transplant during the TKI Era. Blood (2012) doi:10.1182/blood-2012-02-409763