Introduction: Chronic myeloid leukemia (CML) is a clonal myeloproliferative disorder the molecular hallmark of the disease is the BCR-ABL gene rearrangement which occurs as the result of a reciprocal translocation between chromosomes 9 and 22. Imatinib, a small molecule, tyrosine kinase inhibitor (TKI) was the first drug that targeted BCR-ABL. Since the introduction of the first and second generation of TKI the role of allogeneic stem cell transplantation in chronic myeloid leukemia is being reevaluated. With this retrospective analysis our aim was to define the role of allogeneic stem cell transplantation for CML in the tyrosine kinase inhibitor era. The following is a general overview of the role of ASCT in the management of CML.
Material and methods: At the BMT Unit Tîrgu Mureș between 2005–2009 we performed five allogeneic transplantations of high risk CML patients with identical sibling donors.
Results: Two of the patients are at present in complete hematologic and cytogenetic remission with no or minimal immunosuppressive therapy after 6 and respectively 3 years of follow up time. Two of the patients had disease free survival but died from infectious complications appeared in the 3rd and 6th month after the allogeneic stem cell transplantation. One patient had an early relapse with treatment refractory disease and died from the evolution of the disease.
Conclusions: We perform allogeneic stem cell transplantation only in the cases in which we have resistance to first and second generation of tyrosine kinase inhibitors (TKI), intolerance to TKI and if we have a suitable donor.