Tyrosine Kinase Inhibitors and Allogeneic Hematopoietic Cell Transplantation for Chronic Myeloid Leukemia: Targeting Both Therapeutic Modalities
Tyrosine Kinase Inhibitors and Allogeneic Hematopoietic Cell Transplantation for Chronic Myeloid Leukemia: Targeting Both Therapeutic Modalities
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DOI：
10.1177/107327480901600207
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发表时间：
2009-04-01
期刊：
影响因子：
2.6
通讯作者：
Kharfan-Dabaja, Mohamed A.
中科院分区：
文献类型：
--
作者：
Fernandez, Hugo F.;Kharfan-Dabaja, Mohamed A.
背景：异基因造血移植(HCT)是治疗慢性髓系白血病(CML)的主要手段，但酪氨酸激酶抑制剂(TKIs)的出现明显改变了同种异体HCT的使用。方法：作者回顾了他们的经验和已发表的有关TKIs对CML自然病程的影响以及TKIs在治疗CML中的应用和时机的数据。现有的回顾性数据表明，TKI治疗后同种异体血细胞移植是安全的。在有或没有供者淋巴细胞输注的情况下，使用TKI挽救异基因HCT失败的工作正在进行中。结论：虽然异基因HCT治疗仍然有效，但其在CML中的应用时机已经改变，现在被认为是二线或三线治疗。
Background: Due to its curative potential, allogenic hematopoietic transplantation (HCT) was a mainstay of treatment for chronic myeloid leukemia (CML), but the advent of tyrosine kinase inhibitors (TKIs) has markedly altered the use of allogeneic HCT.Methods: The authors reviewed their experiences as well as the published data regarding the impact of TKIs on the natural history of CML and thus on the application and timing of TKIs in the management of CML.Results: Most patients with CML respond well to TKIs given as up-front therapy. Available retrospective data suggest that allogenic HCT is safe after TKI therapy. Work is ongoing regarding salvage of postallogeneic HCT failures using TKIs with and without donor lymphocyte infusion.Conclusions: While allogeneic HCT therapy remains useful, the timing of its application in CML has changed, and it is now considered as second-or third-line therapy.