International Journal of Hematology

, Volume 100, Issue 3, pp 296–306

Effect of graft sources on allogeneic hematopoietic stem cell transplantation outcome in adults with chronic myeloid leukemia in the era of tyrosine kinase inhibitors: a Japanese Society of Hematopoietic Cell Transplantation retrospective analysis

  • Kazuteru Ohashi
  • Tokiko Nagamura-Inoue
  • Fumitaka Nagamura
  • Arinobu Tojo
  • Kouichi Miyamura
  • Takehiko Mori
  • Mineo Kurokawa
  • Shuichi Taniguchi
  • Jun Ishikawa
  • Yasuo Morishima
  • Yoshiko Atsuta
  • Hisashi Sakamaki
Original Article


We retrospectively compared transplant outcomes for related bone marrow transplantation (rBMT), related peripheral blood stem cell transplantation (rPBSCT), unrelated bone marrow transplantation (uBMT), and unrelated cord blood transplantation (CBT) in 1,062 patients with chronic myeloid leukemia (CML) aged 20 years or over between January 1, 2000 and December 31, 2009 in Japan. The disease status was as follows: chronic phase 1 (CP1, n = 531), CP 2 or later including accelerated phase (CP2-AP, n = 342) and blastic crisis (BC, n = 189). Graft sources (GS) were rBMT (n = 205), uBMT (n = 507), rPBSCT (n = 226) or CBT (n = 124). In multivariate analysis in CP1, lower overall survival (OS) (relative risk [RR]: 6.01, 95 % confidence interval [CI]: 1.20–29.97, P = 0.029) and leukemia-free survival (LFS) (RR: 4.26, 95 % CI: 1.24–14.62, P = 0.021) were observed in uBMT compared with those in rBMT. For patients in the advanced phase of CML beyond CP1, GS had no significant impact on OS or LFS. Our results support the use of rBMT for adults with CML in CP1, but in contrast to previous reports, the superiority of rPBSCT in advanced stage of CML was not confirmed in our cohorts.


Chronic myeloid leukemia Allogeneic hematopoietic stem cell transplantation Graft sources 

Supplementary material

12185_2014_1632_MOESM1_ESM.xlsx (13 kb)
Supplementary material 1 (XLSX 13 kb)


  1. 1.
    Cortes J, H Kantarjian. How I treat newly diagnosed chronic phase CML. Blood. 2012;120:1390–7.PubMedCrossRefGoogle Scholar
  2. 2.
    Baccarani M, Cortes J, Pane F, et al. Chronic myeloid leukemia: an update of concepts and management recommendations of European LeukemiaNet. J Clin Oncol. 2009;27:6041–51.PubMedCrossRefGoogle Scholar
  3. 3.
    Hehlmann R, Berger U, Pfirrmann M, et al. Drug treatment is superior to allografting as first line therapy in chronic myeloid leukemia. Blood. 2007;109:4686–92.PubMedCrossRefGoogle Scholar
  4. 4.
    Saussele S, Lauseker M, Gratwohl A, et al. Allogeneic hematopoietic stem cell transplantation for chronic myeloid leukemia in the imatinib era: evaluation of its impact within a subgroup of the randomized German CML Study IV. Blood. 2010;115:1880–5.PubMedCrossRefGoogle Scholar
  5. 5.
    Radich J. Stem cell transplant for chronic myeloid leukemia in the imatinib era. Semin Hematol. 2010;47:354–61.PubMedCentralPubMedCrossRefGoogle Scholar
  6. 6.
    Venepalli N, Rezvani K, Mielke S, et al. Role of allo-SCT for CML in 2010. Bone Marrow Transpl. 2010;45:1579–86.CrossRefGoogle Scholar
  7. 7.
    Cortes JE, Kantarjian H, Shah NP, et al. Ponatinib in refractory Philadelphia chromosome-positive leukemias. N Engl J Med. 2012;367:2075–88.PubMedCentralPubMedCrossRefGoogle Scholar
  8. 8.
    O’Hare T, Shakespeare WC, Zhu X, et al. AP24534, a pan-BCR-ABL inhibitor for chronic myeloid leukemia, potently inhibits the T315I mutant and overcomes mutation-based resistance. Cancer Cell. 2009;16:401–12.PubMedCentralPubMedCrossRefGoogle Scholar
  9. 9.
    Atsuta Y, Suzuki R, Yoshimi A, et al. Unification of hematopoietic stem cell transplantation registries in Japan and establishment of the TRUMP System. Int J Hematol. 2007;86:269–74.PubMedCrossRefGoogle Scholar
  10. 10.
    Przepiorka D, Weisdorf D, Martin P, et al. 1994 Consensus Conference on acute GVHD grading. Bone Marrow Transpl. 1995;15:825–8.Google Scholar
  11. 11.
    Sullivan KM, Agura E, Anasetti C, et al. Chronic graft-versus-host disease and other late complications of bone marrow transplantation. Semin Hematol. 1991;28:250–9.PubMedGoogle Scholar
  12. 12.
    Kanda J. Effect of HLA mismatch on acute graft-versus-host disease. Int J Hematol. 2013;98:300–8.PubMedCrossRefGoogle Scholar
  13. 13.
    Gratwohl A, Brand R, Apperley J, et al. Allogeneic hematopoietic stem cell transplantation for chronic myeloid leukemia in Europe 2006: transplant activity, long-term data and current results. An analysis by the Chronic Leukemia Working Party of the European Group for Blood and Marrow Transplantation (EBMT). Haematologica. 2006;91:513–21.PubMedGoogle Scholar
  14. 14.
    Khoury HJ, Kukreja M, Goldman JM, et al. Prognostic factors for outcomes in allogeneic transplantation for CML in the imatinib era: a CIBMTR analysis. Bone Marrow Transpl. 2012;47:810–6.CrossRefGoogle Scholar
  15. 15.
    Champlin RE, Schmitz N, Horowitz MM, et al. Blood stem cells compared with bone marrow as a source of hematopoietic cells for allogeneic transplantation. IBMTR Histocompatibility and Stem Cell Sources Working Committee and the European Group for Blood and Marrow Transplantation (EBMT). Blood. 2000;95:3702–9.PubMedGoogle Scholar
  16. 16.
    Oehler VG, Radich JP, Storer B, et al. Randomized trial of allogeneic related bone marrow transplantation versus peripheral blood stem cell transplantation for chronic myeloid leukemia. Biol Blood Marrow Transpl. 2005;11:85–92.CrossRefGoogle Scholar
  17. 17.
    Lee SJ, Kukreja M, Wang T, et al. Impact of prior imatinib mesylate on the outcome of hematopoietic cell transplantation for chronic myeloid leukemia. Blood. 2008;112:3500–7.PubMedCentralPubMedCrossRefGoogle Scholar
  18. 18.
    Oehler VG, Gooley T, Snyder DS, et al. The effects of imatinib mesylate treatment before allogeneic transplantation for chronic myeloid leukemia. Blood. 2007;109:1782–9.PubMedCentralPubMedCrossRefGoogle Scholar
  19. 19.
    Perz JB, Khorashad JS, Marin D, et al. Imatinib preceding allogeneic stem cell transplantation in chronic myeloid leukemia. Haematologica. 2006;91:1145–6.PubMedGoogle Scholar
  20. 20.
    Giralt SA, Arora M, Goldman JM, et al. Chronic Leukemia Working Committee, Center for International Blood and Marrow Transplant Research. Impact of imatinib therapy on the use of allogeneic haematopoietic progenitor cell transplantation for the treatment of chronic myeloid leukaemia. Br J Haematol. 2007;137:461–7.PubMedCrossRefGoogle Scholar
  21. 21.
    Deininger M, Schleuning M, Greinix H, et al. The effect of prior exposure to imatinib on transplant-related mortality. Haematologica. 2006;91:452–9.PubMedGoogle Scholar
  22. 22.
    Gluckman E, Rocha V, Boyer-Chammard A, et al. Outcome of cord-blood transplantation from related and unrelated donors. Eurocord Transplant Group and the European Blood and Marrow Transplantation Group. N Engl J Med. 1997;337:373–81.PubMedCrossRefGoogle Scholar
  23. 23.
    Rubinstein P, Carrier C, Scaradavou A, et al. Outcomes among 562 recipients of placental-blood transplants from unrelated donors. N Engl J Med. 1998;339:1565–77.PubMedCrossRefGoogle Scholar
  24. 24.
    Sanz GF, Saavedra S, Jimenez C, et al. Unrelated donor cord blood transplantation in adults with chronic myelogenous leukemia: results in nine patients from a single institution. Bone Marrow Transpl. 2001;27:693–701.CrossRefGoogle Scholar
  25. 25.
    Nagamura-Inoue T, Kai S, Azuma H, et al. Unrelated cord blood transplantation in CML: Japan Cord Blood Bank Network analysis. Bone Marrow Transpl. 2008;42:241–51.CrossRefGoogle Scholar

Copyright information

© The Japanese Society of Hematology 2014

Authors and Affiliations

  • Kazuteru Ohashi
    • 1
  • Tokiko Nagamura-Inoue
    • 2
    • 12
  • Fumitaka Nagamura
    • 3
  • Arinobu Tojo
    • 4
  • Kouichi Miyamura
    • 5
  • Takehiko Mori
    • 6
  • Mineo Kurokawa
    • 7
  • Shuichi Taniguchi
    • 8
  • Jun Ishikawa
    • 9
  • Yasuo Morishima
    • 10
    • 13
  • Yoshiko Atsuta
    • 11
    • 14
  • Hisashi Sakamaki
    • 1
    • 14
  1. 1.Hematology Division, Tokyo Metropolitan Cancer and Infectious Disease CenterKomagome HospitalTokyoJapan
  2. 2.Department of Cell Processing and Transfusion, Research Hospital, The Institute of Medical ScienceThe University of TokyoTokyoJapan
  3. 3.Division of Clinical Trial Safety Management, Research Hospital, The Institute of Medical ScienceThe University of TokyoTokyoJapan
  4. 4.Department of Hematology/Oncology, Research Hospital, The Institute of Medical ScienceThe University of TokyoTokyoJapan
  5. 5.Department of HematologyJapanese Red Cross Nagoya Daiichi HospitalNagoyaJapan
  6. 6.Division of Hematology, Department of MedicineKeio University School of MedicineTokyoJapan
  7. 7.Department of Cell Therapy and Transplantation MedicineThe University of TokyoTokyoJapan
  8. 8.Department of HematologyToranomon HospitalTokyoJapan
  9. 9.Department of Hematology and ChemotherapyOsaka Medical Center for Cancer and Cardiovascular DiseasesOsakaJapan
  10. 10.Division of Epidemiology/PreventionAichi Cancer Center Research InstituteNagoyaJapan
  11. 11.Department of HSCT Data Management/BiostatisticsNagoya University Graduate School of MedicineNagoyaJapan
  12. 12.Japan Cord Blood Bank NetworkTokyoJapan
  13. 13.Japan Marrow Donor ProgramTokyoJapan
  14. 14.Japanese Society of Hematopoietic Cell TransplantationNagoyaJapan

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