Overall survival of chronic myeloid leukemia patients treated with related donor hematopoietic stem cell transplant or imatinib.

Objective: To determine the overall survival (OS) of Ph1 positive chronic myeloid leukemia (CML) patients treated with allogeneic hematopoietic stem cell transplant (AHSCT) vs. imatinib.

Material And Methods: We retrospectively included CML patients treated with related donor myeolablative and non-myeloablative AHSCT, between 1992 and 2009. Another group consisted of a patient cohort treated with imatinib between 2001 and 2009. The main variable was the persistence of hematologic remission.

Results: The AHSCT/ imatinib groups included 36/46 patients, average age was 36/46, patients in chronic phase 34/44 and in blastic phase, 2/2. The number of myeloablative/non-myeloablative transplants was 28/8. Imatinib was administered at a dose of 400 to 800 mg/day (median 500 mg). The following events developed in both groups: death 14/3, hematological progression 4/5, 17/41 are alive and in hematological remission (p = 0.00009). The OS probability is 0.42 and 0.76 at 100 months (p = 0.0001). The decrease in absolute risk is 42%. The OS after 17 years remains unmodified in the AHSCT group after the first 6 years.

Conclusion: OS at 100 months is superior with imatinib than with AHSCT (p = 0.0001).