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, Marcos De Lima*

*Corresponding author for this work

Research output: Contribution to journalArticle

76 Scopus citations

Abstract

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 non-ablative (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.

Original languageEnglish (US)
Pages (from-to)1421-1423
Number of pages3
JournalBlood
Volume108
Issue number4
DOIs
StatePublished - Aug 15 2006

ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

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    Jabbour, E., Cortes, J., Kantarjian, H. M., Giralt, S., Jones, D., Jones, R., Giles, F., Andersson, B. S., Champlin, R., & De Lima, M. (2006). Allogeneic stem cell transplantation for patients with chronic myeloid leukemia and acute lymphocytic leukemia after Bcr-Abl kinase mutation-related imatinib failure. Blood, 108(4), 1421-1423. https://doi.org/10.1182/blood-2006-02-001933