Hematology & Stem Cell Transplant Team, University Hospital, Petersgraben, CH-4031, University of Basel, Basel, Switzerland.
Best Pract Res Clin Haematol. 2009 Sep;22(3):431-43. doi: 10.1016/j.beha.2009.05.002.
Haematopoietic stem cell transplantation (HSCT) has seen considerable ups and downs in its role for patients with chronic myeloid leukaemia (CML). It has provided the first proof of the principle for cure and has confirmed the concept of successful immunotherapy of leukaemia. CML became the most frequent indication for an allogeneic HSCT worldwide. The frequency of HSCT declined rapidly when the specific BCR/ABL tyrosine kinase inhibitor (TKI) imatinib appeared. Today, a balanced view prevails. Risk assessment of both, disease risk and transplant risk, has become standard. Allogeneic HSCT remains the first-line approach for patients with CML in accelerated phase or blast crisis. It is the standard of care for patients with failed first-line therapy and a low-risk HSCT. It is the best option for all patients with failed second-line TKIs, with mutations T315I or with progressive disease. It can always be considered in situations with limited resources.
造血干细胞移植（HSCT）在治疗慢性髓性白血病（CML）患者方面经历了巨大的起伏。它为治愈原则提供了第一个证据，并证实了白血病成功免疫治疗的概念。CML 成为全球最常见的异基因 HSCT 适应证。当特定的 BCR/ABL 酪氨酸激酶抑制剂（TKI）伊马替尼出现时，HSCT 的频率迅速下降。如今，人们的观点趋于平衡。疾病风险和移植风险的评估已成为标准。对于加速期或急变期的 CML 患者，异基因 HSCT 仍然是首选方法。对于一线治疗失败且 HSCT 风险低的患者，它是标准的治疗方法。对于所有二线 TKI 治疗失败、有 T315I 突变或疾病进展的患者，它是最佳选择。在资源有限的情况下，它也始终可以被考虑。
