AI Article Synopsis
- The use of tyrosine kinase inhibitors (TKIs) has limited hematopoietic cell transplant (HCT) to CML patients who don't respond to or can't tolerate TKIs, though HCT remains a front-line treatment in some regions due to its long-term cost-effectiveness.
- Advances in HCT techniques, such as intravenous busulfan and enhanced supportive care, have led to better outcomes and lower mortality rates for CML patients.
- The evolution of reduced-intensity regimens, molecular donor matching, and alternative donor options has broadened HCT eligibility, with about 1,000 procedures performed annually for CML between 2006 and 2010.
Article Abstract
The development and widespread use of tyrosine kinase inhibitors (TKIs) has relegated the use of hematopoietic cell transplant (HCT), in most countries, to chronic myeloid leukemia (CML) patients who fail or are intolerant to TKIs. Its long-term cost effectiveness compared to TKIs, however, has maintained its use as front-line treatment in some areas. Advances in HCT, including the development of intravenous busulfan and plasma assays permitting dose adjustment, have improved results of HCT in CML. Improved supportive care has lowered the incidence of non-relapse mortality and improved survival. The availability of reduced-intensity preparative regimens, molecular typing of unrelated donors, and the use of cord blood and haploidentical donors has expanded the application of HCT to nearly any patient with an appropriate indication. From 2006 to 2010, approximately one thousand HCTs were performed annually in patients with CML. Better understanding of recent advances will improve the appropriate use and results of HCT in patients with CML.
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