Barrett A John, Ito Sawa
Stem Cell Allotransplantation Section, Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD.
Blood. 2015 May 21;125(21):3230-5. doi: 10.1182/blood-2014-10-567784. Epub 2015 Apr 7.
The introduction of tyrosine kinase inhibitors (TKIs), a treatment of chronic myelogenous leukemia (CML), has largely replaced curative strategies based on allogeneic stem cell transplantation (SCT). Nevertheless, SCT still remains an option for accelerated/blastic-phase and selected chronic-phase CML. Transplant outcomes can be optimized by peritransplant TKIs, conditioning regimen, BCR-ABL monitoring, and relapse management. Controversies exist in transplant timing, pediatric CML, alternative donors, and economics. SCT continues to serve as a platform of "operational cure" for CML with TKIs and immunotherapies.
酪氨酸激酶抑制剂(TKIs)作为慢性髓性白血病(CML)的一种治疗方法,已在很大程度上取代了基于异基因干细胞移植(SCT)的治愈性策略。尽管如此,SCT仍是加速期/急变期以及部分慢性期CML的一种选择。围移植期使用TKIs、预处理方案、BCR-ABL监测及复发管理可优化移植结局。在移植时机、儿童CML、替代供体及经济学方面仍存在争议。SCT继续作为CML采用TKIs和免疫疗法实现“操作性治愈”的一个平台。