BACKGROUND/AIMS: The aim of this study was to identify the role of transcript level as a predictor for post-transplant relapse and outcome in patients who underwent allogeneic stem cell transplantation (SCT) for chronic phase (CP) chronic myeloid leukemia (CML).

METHODS

Of 101 patients receiving allograft in CML CP, 85 had available quantitative reverse transcriptase polymerase chain reaction data at post-transplant 3 months. These patients were divided into two groups according to molecular response (MR), defined as a transcript level ≤ 0.0032% on the international scale, at 3 months based on receiver operating characteristic curve analysis of relapse.

RESULTS

The 4-year overall survival and event-free survival (EFS) were 80.6% and 57.3%, respectively, and the cumulative incidence of relapse at 4 years was 29.6% after a median follow-up of 126.4 months. We performed multivariate analyses including potential variables to evaluate the early predictive role of MR at 3 months and found that MR at 3 months was associated with a higher EFS ( = 0.028) and showed a trend for a lower relapse rate ( = 0.089).

CONCLUSIONS

our results imply that frequent molecular monitoring and immune suppressive therapy modulation are required for patients without reduction of transcripts to this level after SCT.