Long-Term Survival Of Patients With Chronic Phase Chronic Myeloid Leukemia Who Received Autologous Stem Cell Transplantation And Further Exposed To Tyrosine Kinase Inhibitors. A Study On Behalf Of The French Society Of Blood And Marrow Transplantation And The French Group Of Cml

Background: Prior to the introduction of tyrosine kinase inhibitors (TKI), the median survival of chronic phase chronic myeloid leukemia (CP-CML) patients was approximately 60 months [Roy L et al, Blood 2006] and the standard treatment with interferon-alpha resulted in complete cytogenetic responses in about 30% of the patients [Bonifazi F. et al, Blood 2001]. Peripheral blood autologous stem cell transplantation (Auto-SCT) was first attempted for patients in transformation in order to restore a second CP and was introduced secondarily in CP to try to prolong the response. The principal rationale for autografting in CP resides on the reduction of the tumor burden and the number of leukemic cells at risk of developing blastic transformation, and the possibility of eradicating already mutated cells. In addition, it takes advantage as well of the endogenous mobilization in the circulation of Ph- HSCs. Nevertheless, Auto-SCT alone was not able to maintain a long-term cytogenetic and/or molecular remission. Nowadays, TKIs represent the state-of-the-art therapy for CML and the concept of Auto-SCT has only little interest while long-term follow-up and outcome in this setting are currently unknown.