Purpose of Technology: Patients with chronic myelogenous leukemia (CML) have an overproduction of partially mature white blood cells of the myeloid lineage. High doses of chemotherapy and/or radiotherapy can destroy bone marrow producing the abnormal cells but normal cells are also affected. Allogeneic hematopoietic stem cell transplantation (HSCT) is a procedure that uses stem cells derived from the peripheral blood or bone marrow of matched related or unrelated donors, which are infused into the transplant recipient where they migrate to the bone marrow and help reestablish normal hematopoiesis. The goals of pretransplant conditioning regimens with chemotherapy drugs and immunosuppressants are to reduce the burden of tumor cells by inducing a graft-versus-leukemia effect while preventing graft rejection and severe immunosuppression using treatments with varying intensities.
Relevant Questions:
- Do less intensive pretransplant conditioning regimens improve survival for CML patients undergoing allogeneic HSCT at least as effectively as myeloablative conditioning (MAC)?
- Does pre-HSCT treatment with the tyrosine kinase inhibitor imatinib or with interferon improve survival for CML patients?
- Do less intensive preconditioning regimens lead to a similar or higher rate of hematologic responses after allogeneic HSCT compared with MAC?
- How do pretransplant drug regimens and conditioning strategies for allogeneic HSCT compare in terms of safety?
- Have definitive patient selection criteria been established for the various conditioning regimens for HSCT for CML?
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