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Second Generation Tyrosine Kinase Inhibitors Combined With Allogeneic Hematopoietic Stem Cell Transplantation Improve the Prognosis of Patients with Chronic Myelogenous Leukemia in Blast Crisis

Zhengping Yu, Jia-hua Ding, Aining Sun, Zheng Ge, Baoan Chen and Wenduo He

The prognosis for patients with Chronic Myelogenous Leukemia (CML) in Blastic Crisis (BC) is poor, with a median survival of only 3-6 months. Blast crisis (BC) is highly refractory to therapy and has a poor prognosis. To determine the efficacy of TKIs-II combined with allogeneic hematopoietic stem cell transplantation (allo-HSCT) in CML BC, we present four consecutive, recent cases of CML BC in which TKIs-II were used before or after allo-HSCT. Patient 1, a 28-year-old male received a HSCT from a half-matched, related-donor. Patient 2, 3 received an HLAidentical unrelated-donor HSCT. To date, patients 1,2,3 and 4 have survived postprocedure for 22, 23, 21 and 25 months, respectively. We conclude that compared with imatinib, TKIs-II may reduce tumor burden more rapidly and thoroughly when administered before or after allo-HSCT and enhance the graft versus leukemia effect, prolonging the long-term survival of patients. We speculate that GVL and tumor burden are negatively correlated.