Allogeneic stem cell transplantation for patients harboring T315I BCR-ABL mutated leukemias
Menée sur 64 patients atteints d'une leucémie avec mutations BCR-ABLT315I, cette étude évalue l'efficacité d'une greffe allogénique de cellules souches sur la survie (durées médianes de suivi : 52 mois après la détection de la mutation, 26 mois après la greffe)
T315I+ Ph+ leukemias are inherently resistant to all licensed TKI and therapeutic options remain limited. We report the outcome of allogeneic SCT in 64 patients with documented BCR-ABLT315I mutations. Median follow-ups were 52 months from mutation detection and 26 months from transplantation. At transplant, 51.5% of CML patients were in CP and 40.5% in advanced phases. Median overall survival from transplant was 10.3 (5.7-NR) months for BP and 7.4 (1.4-NR) months for Ph+ ALL but has not yet been reached for CP and AP. The occurrence of chronic GVHD had a positive impact on overall survival (p=0.047). TRM rates were low. Multivariate analysis identified only BP at transplant (HR 3.68, p=0.0011) and unrelated stem cell donor (HR 2.98, p=0.011) as unfavorable factors. Before the availability of third generation TKI, we conclude that allogeneic SCT represents a valuable therapeutic tool for eligible patients with BCR-ABLT315I mutation; a tool which may or may not be replaced by third generation TKI.