Abstract:
Hematopoietic stem cell transplantation (HSCT) for chronic myeloid leukemia (CML) patients has transitioned from the standard of care to a treatment option limited to those with unsatisfactory tyrosine kinase inhibitor (TKI) responses and advanced disease stages. In recent years, the threshold for undergoing HSCT has increased. Most CML patients now have life expectancies comparable to the general population, and therefore, the goal of therapy is shifting toward achieving treatment-free remission (TFR). While TKI discontinuation trials in CML show potential for achieving TFR, relapse risk is high, affirming allogeneic HSCT as the sole curative treatment. HSCT should be incorporated into treatment algorithms from the time of diagnosis and, in some patients, evaluated as soon as possible. In this review, we will look at some of the recent advances in HSCT, as well as its indication in the era of aiming for TFR in the presence of TKIs in CML.
摘要:
慢性粒细胞白血病(CML)患者的造血干细胞移植(HSCT)已从标准护理转变为仅限于酪氨酸激酶抑制剂(TKI)反应和晚期疾病阶段的治疗选择。近年来,接受HSCT的阈值增加了。现在大多数CML患者的预期寿命与普通人群相当,因此,治疗的目标正在转向实现无治疗缓解(TFR).虽然CML中的TKI停药试验显示出实现TFR的潜力,复发风险很高,确认同种异体HSCT是唯一的治愈性治疗。从诊断开始,HSCT应纳入治疗算法,在一些患者中,尽快评估。在这次审查中,我们将看看HSCT的一些最新进展,以及它在CML中存在TKIs的情况下瞄准TFR的时代的指示。