Allogeneic stem cell transplantation for patients with chronic myeloid leukemia and acute lymphocytic leukemia after BCR-ABL kinase mutation-related imatinib failure

摘要: Resistance to imatinib mesylate is an emerging problem in the treatment of chronic myeloid leukemia (CML), often associated with point mutations Bcr-Abl kinase domain. Outcome patients such after allogeneic stem cell transplantation (Allo-SCT) unknown. Ten imatinib-resistant received a transplant: 9 had CML (3 phase, 4 accelerated and 2 blast phase) 1 Philadelphia-positive acute lymphocytic (ALL). Patients harbored different protein (T315I mutation, n = 2). Preparative regimens were ablative (n 7) nonablative 3). All engrafted; there no treatment-related deaths. Disease response was complete molecular (CMR; 7), major 2), 1). Three (mutations Q252H, E255K, T315I) died relapse Allo-SCT. Seven are alive (6 CMR) for median 19 months. Allo-SCT remains important salvage option who develop resistance through mutations.