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Blood, 15 August 2006, Vol. 108, No. 4, pp. 1421-1423.
Prepublished online as a Blood First Edition Paper on April 6, 2006; DOI 10.1182/blood-2006-02-001933.
 Previous Article | Table of Contents
TRANSPLANTATION
Brief report
Allogeneic stem cell transplantation for patients with chronic myeloid leukemia and acute lymphocytic leukemia after Bcr-Abl kinase mutation–related imatinib failure
Elias Jabbour,
Jorge Cortes,
Hagop M. Kantarjian,
Sergio Giralt,
Dan Jones,
Roy Jones,
Francis Giles,
Borje S. Andersson,
Richard Champlin, and
Marcos de Lima
From the Departments of Blood and Marrow Transplantation, Leukemia, and Hematopathology, University of Texas M. D. Anderson Cancer Center, Houston.
Resistance to imatinib mesylate is an emerging problem in the treatment of chronic myeloid leukemia (CML), often associated with point mutations in the Bcr-Abl kinase domain. Outcome of patients with such mutations after allogeneic stem cell transplantation (Allo-SCT) is unknown. Ten imatinib-resistant patients with Bcr-Abl kinase mutations received a transplant: 9 had CML (3 in chronic phase, 4 in accelerated phase, and 2 in blast phase) and 1 had Philadelphia-positive acute lymphocytic leukemia (ALL). Patients harbored 9 different protein kinase mutations (T315I mutation, n = 2). Preparative regimens were ablative (n = 7) and nonablative (n = 3). All patients engrafted; there were no treatment-related deaths. Disease response was complete molecular (CMR; n = 7), major molecular (n = 2), and no response (n = 1). Three patients (mutations Q252H, E255K, and T315I) died of relapse after Allo-SCT. Seven patients are alive (6 in CMR) for a median of 19 months. Allo-SCT remains an important salvage option for patients who develop resistance to imatinib through Bcr-Abl mutations.
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