Table 1.
Patient and treatment characteristics.
| Patient | Age at HSCT | Sex | Disease phase at diagnosis | Indication for HSCT | Months to HSCT | Time on imatinib: best response | 2nd generation TKI use: best response and molecular response pre-HSCT | Disease phase pre-HSCT | Donor type and matching | Conditioning |
|---|---|---|---|---|---|---|---|---|---|---|
| 1 | 61 | M | AP | Previous AP including clonal evolution | 23 | 18 months: CCyR | Nilotinib 4 months: CCyR | 2nd CP | VUD 10/10 match | Flu/Bu/Campath |
| 2 | 64 | M | CP | 1° resistance 1st generation TKI, 2° resistance 2nd generation TKI | 27 | 20 months:PCyR | 1.Dasatinib 3 months: CCyR | 2nd CP | SIB | FLu/Mel/Campath |
| 2. Nilotinib 3 months: CHR | 10/10 match | |||||||||
| 3 | 35 | M | AP | Previous AP, 2° resistance 1st and 2nd generation TKis | 29 | 19 months: MCyR | Dasatinib 8 months: CCyR | 2nd CP | VUD | TBI/Cyclo/Campath |
| Lost CCyR and in CHR pre-HSCT | 10/10 match | |||||||||
| 4 | 52 | M | CP | 1°reistance 1st and 2nd generation TKIs | 22 | 9 months: CHR only | 1.Dasatinib 8 months: CHR only | 1st CP | VUD | Flu/Mel/Campath |
| 2. Nilotinib 5 months: CHR only | 10/10 match | |||||||||
| 5 | 50 | M | AP | Previous myeloid blast crisis, 1° resistance to 1st and 2nd generation TKIs | 10 | 5 months: CHR only | 1.Nilotinib: 3 months: disease progression | 2nd CP | VUD | Treo/Cyclo/Campath |
| 2.Dasatinib 3 months: PCyR(pleural effusions) | 10/10 match | |||||||||
| 6 | 50 | F | AP | Previous lymphoid blast crisis | 21 | 16 months: CCyR | Dasatinib 4 months: CCyR | 2nd CP | *1. SIB 9/10 match (‘A’ antigen mismatch) | 1. Treo/Cyclo/Campath |
| 2. VUD 10/10 match | 2. Flu/Bu/Campath | |||||||||
| 7 | 34 | M | CP | Previous AP and poor tolerance TKIs | 36 | 7 months: PHR | Dasatinib 28 months: CCyR | 2nd CP | Volunteer unrelated donor | TBI/Cyclo/Campath |
| 10/10 match | ||||||||||
| 8 | 41 | M | CP | Previous myeloid blast crisis | 25 | 18 months: CHR | Dasatinib 6 months: CHR only | 3rd CP | VUD | Flu/Mel |
| 10/10 match | Campath | |||||||||
| 9 | 45 | F | CP | 1° resistance to 1st and 2nd generation TKIs | 26 | 14 months: CHR | 1. Nilotinib 9 months: CHR only | AP | VUD | Treo/Cyclo/Campath |
| 2. Dasatinib 2 months: disease progression | 9/10 match (‘A’ antigen mismatch) |
Abbreviations: HSCT indicates haematopoietic stem cell transplant, CP indicates chronic phase; AP accelerated phase; VUD indicates volunteer unrelated donor; SIB is a sibling donor; CCyR is complete cytogenetic response, MCyR is a major cytogenetic response, PCyR is partial cytogenetic response, CHR is complete haematological response, PHR is partial haematological response (or incomplete haematological response)
Flu/Bu/Campath is Fludarabine (30 mg/m2 day 7 to 3)/Cyclophosphamide (60 mg/kg day 3 and 2) and alemtuzumab (20 mg day 8, 10 mg bd day 7 to day 4); Flu/Mel/Campath is Fludarabine (30 mg/m2 day 7 to 3)/Melphalan (140 mg/m2 day 2) and alemtuzumab, (20 mg day 8, 10 mg bd day 7 to 4) TBI/Cyclo/Campath is total body irradiation (1440 Gy in 8 fractions)/Cyclophosphamide (60 mg/kg day 3 and 2)and alemtuzumab(10 mg, day 5 to 1) Treo/Cyclo/Campath is Treosulphan (14 g/m2), Cyclophosphamide (60 mg/kg day 3 and 2) and alemtuzumab (20 mg day 8, 10 mg bd day 7 to 4).
This patient received 2 times HSCT owing to secondary graft failure of first HSCT which was an ‘A’ antigen mismatch.