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 Ph-1 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).