PMID- 24252361
OWN - NLM
STAT- MEDLINE
DCOM- 20141031
LR  - 20140127
IS  - 2152-2669 (Electronic)
IS  - 2152-2669 (Linking)
VI  - 14
IP  - 1
DP  - 2014 Feb
TI  - A comparison of long-term outcomes of donor lymphocyte infusions and tyrosine 
      kinase inhibitors in patients with relapsed CML after allogeneic hematopoietic 
      cell transplantation.
PG  - 87-92
LID - S2152-2650(13)00431-X [pii]
LID - 10.1016/j.clml.2013.09.010 [doi]
AB  - BACKGROUND: Donor lymphocyte infusion (DLI) and tyrosine kinase inhibitors (TKIs) 
      are the 2 standard treatment options in chronic myeloid leukemia (CML) that 
      relapses after hematopoietic cell transplantation (HCT), but reports comparing 
      long-term outcomes of these modalities are rare. PATIENTS AND METHODS: A total of 
      46 patients were treated with either DLI (n = 28) or TKIs (n = 18) during a first 
      relapse of CML after HCT between 1993 and 2012. The stage of relapse was the 
      chronic phase in 37 patients and the advanced phase in 9 patients. All patients 
      had myeloablative conditioning without T-cell depletion during HCT. The median 
      interval between HCT and treatment for relapse was 34 (range, 2-197) months. 
      RESULTS: At a median follow-up of 146 and 70 months, respectively, 32% of the DLI 
      group and 33% of the TKI group had died. Six (21%) patients initially treated 
      with DLI received TKIs during a second relapse. In multivariable analyses, DLI 
      was associated with inferior overall survival (OS) (hazard ratio [HR], 37.4; 95% 
      confidence interval [CI], 2.2-625.4; P = .01), shorter failure-free survival 
      (FFS) (HR, 21.15; 95% CI, 1.8-251; P = .02), higher cumulative incidence of 
      failure (CIF) (HR, 19.5; 95% CI, 1.6-236.5; P = .02), and increased incidence of 
      treatment-induced graft vs. host disease (GVHD) (68% vs. 6%; P = .001). 
      CONCLUSION: TKIs appear better than DLI in chronic-phase relapses after 
      myeloablative non-T-cell-depleted HCT. Outcomes were poor in advanced-phase 
      relapses irrespective of treatment modality.
CI  - Copyright (c) 2014 Elsevier Inc. All rights reserved.
FAU - Shanavas, Mohamed
AU  - Shanavas M
AD  - Allogeneic Blood and Marrow Transplantation Program, Princess Margaret Cancer 
      Centre, Toronto, Ontario, Canada. Electronic address: mohamed.shanavas@uhn.ca.
FAU - Messner, Hans A
AU  - Messner HA
AD  - Allogeneic Blood and Marrow Transplantation Program, Princess Margaret Cancer 
      Centre, Toronto, Ontario, Canada.
FAU - Kamel-Reid, Suzanne
AU  - Kamel-Reid S
AD  - Department of Pathology, University Health Network, Toronto, Ontario, Canada.
FAU - Atenafu, Eshetu G
AU  - Atenafu EG
AD  - Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, Ontario 
      Canada.
FAU - Gupta, Vikas
AU  - Gupta V
AD  - Allogeneic Blood and Marrow Transplantation Program, Princess Margaret Cancer 
      Centre, Toronto, Ontario, Canada.
FAU - Kuruvilla, John
AU  - Kuruvilla J
AD  - Allogeneic Blood and Marrow Transplantation Program, Princess Margaret Cancer 
      Centre, Toronto, Ontario, Canada.
FAU - Kim, Dennis Dong Hwan
AU  - Kim DD
AD  - Allogeneic Blood and Marrow Transplantation Program, Princess Margaret Cancer 
      Centre, Toronto, Ontario, Canada.
FAU - Uhm, Jieun
AU  - Uhm J
AD  - Allogeneic Blood and Marrow Transplantation Program, Princess Margaret Cancer 
      Centre, Toronto, Ontario, Canada.
FAU - Lambie, Anna
AU  - Lambie A
AD  - Allogeneic Blood and Marrow Transplantation Program, Princess Margaret Cancer 
      Centre, Toronto, Ontario, Canada.
FAU - Ellis, Laura
AU  - Ellis L
AD  - Allogeneic Blood and Marrow Transplantation Program, Princess Margaret Cancer 
      Centre, Toronto, Ontario, Canada.
FAU - Lipton, Jeffrey H
AU  - Lipton JH
AD  - Allogeneic Blood and Marrow Transplantation Program, Princess Margaret Cancer 
      Centre, Toronto, Ontario, Canada.
LA  - eng
PT  - Journal Article
DEP - 20131001
PL  - United States
TA  - Clin Lymphoma Myeloma Leuk
JT  - Clinical lymphoma, myeloma & leukemia
JID - 101525386
RN  - 0 (Protein Kinase Inhibitors)
RN  - EC 2.7.10.1 (Protein-Tyrosine Kinases)
SB  - IM
MH  - Adult
MH  - Female
MH  - Granulocyte Precursor Cells/drug effects/metabolism
MH  - Hematopoietic Stem Cell Transplantation/methods
MH  - Humans
MH  - Leukemia, Myelogenous, Chronic, BCR-ABL Positive/*drug therapy/surgery/*therapy
MH  - Lymphocyte Transfusion/methods
MH  - Male
MH  - Middle Aged
MH  - Neoplasm Recurrence, Local/*drug therapy/surgery/*therapy
MH  - Protein Kinase Inhibitors/*therapeutic use
MH  - Protein-Tyrosine Kinases/*antagonists & inhibitors
MH  - T-Lymphocytes/drug effects/metabolism
MH  - Transplantation Conditioning/methods
OTO - NOTNLM
OT  - Chronic myeloid leukemia
OT  - Donor lymphocyte infusion
OT  - Hematopoietic cell transplantation
OT  - Relapse
OT  - Tyrosine kinase inhibitor
EDAT- 2013/11/21 06:00
MHDA- 2014/11/02 06:00
CRDT- 2013/11/21 06:00
PHST- 2013/06/17 00:00 [received]
PHST- 2013/09/09 00:00 [revised]
PHST- 2013/09/24 00:00 [accepted]
PHST- 2013/11/21 06:00 [entrez]
PHST- 2013/11/21 06:00 [pubmed]
PHST- 2014/11/02 06:00 [medline]
AID - S2152-2650(13)00431-X [pii]
AID - 10.1016/j.clml.2013.09.010 [doi]
PST - ppublish
SO  - Clin Lymphoma Myeloma Leuk. 2014 Feb;14(1):87-92. doi: 
      10.1016/j.clml.2013.09.010. Epub 2013 Oct 1.