Is Imatinib Maintenance Required for Patients with Relapse Chronic Myeloid Leukemia Post-Transplantation Obtaining CMR? A Pilot Retrospective Investigation

PLoS One. 2013 Jun 18;8(6):e65981. doi: 10.1371/journal.pone.0065981. Print 2013.

Abstract

Imatinib can induce complete molecular remission (CMR) in relapse chronic myelogenous leukemia (CML) after allogeneic hematopoietic stem cell transplantation, but it is indefinite whether imatinib is required to maintain CMR. We retrospectively reviewed 37 relapse CML post-transplants treated with imatinib (n = 20) or donor lymphocyte infusion (DLI) (n = 17). The rate of CMR was 85% and 76.47% (P = 0.509) and treatment-related mortality was 0% and 29.4% (P = 0.019), respectively, in imatinib and DLI groups. Fifteen patients obtaining CMR voluntarily ceased imatinib, and did not experience relapse. The 8-year overall survival (OS) after relapse was 85%±8% and 40.3±12.1% (P = 0.017), and disease-free survival (DFS) after relapse was 85%±8% and 40.3±12.1% (P = 0.011), respectively, in imatinib and DLI groups. Imatinib resulted in higher OS and DFS than that of DLI in relapse CML. Imatinib maintenance might not be required for patients with relapse CML post-transplants after they achieved full donor chimerism and CMR.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Antineoplastic Agents / administration & dosage*
  • Child
  • Female
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Imatinib Mesylate / administration & dosage*
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy*
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / therapy
  • Male
  • Middle Aged
  • Pilot Projects
  • Recurrence
  • Retrospective Studies
  • Survival Analysis
  • Young Adult

Substances

  • Antineoplastic Agents
  • Imatinib Mesylate

Grants and funding

The study was supported by grants from the National Natural Science Foundation of China (No.81000231, No.81270647, and No.30971300), the National Public Health Grand Research Foundation of China (No. 201202017) the Technology Plan of Guangdong Province of China (No.2009A030200007) and the Science and Technology Project of Guangdong Province of China (No.2011J4300104). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.