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Current status and perspectives of tyrosine kinase inhibitor treatment in the posttransplant period in patients with chronic myelogenous leukemia (CML).
Biol Blood Marrow Transplant 2010; 16(3):301-10BB

Abstract

Following the introduction of tyrosine kinase inhibitors (TKIs) in chronic myelogenous leukemia (CML), allogeneic stem cell transplantation (SCT) took a shift toward high-risk patients. Considering the high relapse rates posttransplant in these selected patients, several studies evaluated posttransplant use of the TKI imatinib. Although the number of studies are still limited, and data have to be confirmed by additional studies, safety of imatinib even within the first months after SCT seems to be acceptable. Imatinib was shown to be effective in patients with molecular or hematologic relapse of chronic or accelerated phase posttransplant (CP, AP), whereas outcomes in blast phase were more unfavorable. The compound further seemed beneficial for prophylactic use in patients who achieved complete remission posttransplant. The combination of imatinib with donor lymphocytes did not result in increased toxicity or graft-versus-host disease (GVHD). First studies suggest that second-generation TKIs such as dasatinib or nilotinib are manageable posttransplant with acceptable toxicity as well. In conclusion, TKIs of the first- and second-generation are promising options for the posttransplant period of patients with CML, but algorithms for dosage, intervals from SCT, duration of application, and the combination with donor lymphocytes still have to be developed.

Authors+Show Affiliations

Interdisciplinary Clinic for Stem Cell Transplantation, University of Aachen, Germany.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

19744571

Citation

Klyuchnikov, Evgeny, et al. "Current Status and Perspectives of Tyrosine Kinase Inhibitor Treatment in the Posttransplant Period in Patients With Chronic Myelogenous Leukemia (CML)." Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation, vol. 16, no. 3, 2010, pp. 301-10.
Klyuchnikov E, Kröger N, Brummendorf TH, et al. Current status and perspectives of tyrosine kinase inhibitor treatment in the posttransplant period in patients with chronic myelogenous leukemia (CML). Biol Blood Marrow Transplant. 2010;16(3):301-10.
Klyuchnikov, E., Kröger, N., Brummendorf, T. H., Wiedemann, B., Zander, A. R., & Bacher, U. (2010). Current status and perspectives of tyrosine kinase inhibitor treatment in the posttransplant period in patients with chronic myelogenous leukemia (CML). Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation, 16(3), pp. 301-10. doi:10.1016/j.bbmt.2009.08.019.
Klyuchnikov E, et al. Current Status and Perspectives of Tyrosine Kinase Inhibitor Treatment in the Posttransplant Period in Patients With Chronic Myelogenous Leukemia (CML). Biol Blood Marrow Transplant. 2010;16(3):301-10. PubMed PMID: 19744571.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Current status and perspectives of tyrosine kinase inhibitor treatment in the posttransplant period in patients with chronic myelogenous leukemia (CML). AU - Klyuchnikov,Evgeny, AU - Kröger,Nicolaus, AU - Brummendorf,Tim H, AU - Wiedemann,Bettina, AU - Zander,Axel Rolf, AU - Bacher,Ulrike, Y1 - 2009/09/08/ PY - 2009/05/30/received PY - 2009/08/31/accepted PY - 2009/9/12/entrez PY - 2009/9/12/pubmed PY - 2010/5/29/medline SP - 301 EP - 10 JF - Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation JO - Biol. Blood Marrow Transplant. VL - 16 IS - 3 N2 - Following the introduction of tyrosine kinase inhibitors (TKIs) in chronic myelogenous leukemia (CML), allogeneic stem cell transplantation (SCT) took a shift toward high-risk patients. Considering the high relapse rates posttransplant in these selected patients, several studies evaluated posttransplant use of the TKI imatinib. Although the number of studies are still limited, and data have to be confirmed by additional studies, safety of imatinib even within the first months after SCT seems to be acceptable. Imatinib was shown to be effective in patients with molecular or hematologic relapse of chronic or accelerated phase posttransplant (CP, AP), whereas outcomes in blast phase were more unfavorable. The compound further seemed beneficial for prophylactic use in patients who achieved complete remission posttransplant. The combination of imatinib with donor lymphocytes did not result in increased toxicity or graft-versus-host disease (GVHD). First studies suggest that second-generation TKIs such as dasatinib or nilotinib are manageable posttransplant with acceptable toxicity as well. In conclusion, TKIs of the first- and second-generation are promising options for the posttransplant period of patients with CML, but algorithms for dosage, intervals from SCT, duration of application, and the combination with donor lymphocytes still have to be developed. SN - 1523-6536 UR - https://www.unboundmedicine.com/medline/citation/19744571/Current_status_and_perspectives_of_tyrosine_kinase_inhibitor_treatment_in_the_posttransplant_period_in_patients_with_chronic_myelogenous_leukemia__CML__ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1083-8791(09)00400-5 DB - PRIME DP - Unbound Medicine ER -