Imatinib In Patients Who Relapse After Allogeneic Stem Cell Transplantation

The incidence of relapse after allo-SCT depends on a number of factors, including the phase of disease at the time of transplant, the nature of the conditioning regimen, the degree of histocompatibility between donor and recipient, and the techniques used to prevent or minimize GvHD. It is probable also that features intrinsic in the patient's disease are also relevant, although there is no definite association between Sokal score and probability of relapse. Until recently the standard approach to managing a patient with CML who relapsed after allo-SCT was to infuse lymphocytes (donor lymphocyte infusions, DLI) collected from the original transplant donor. However, recent experience shows that such relapses respond very well to IM, but the disease frequently recurs when the imatinib is discontinued (64,65). This may mean that DLI has a more durable effect than IM and the decision whether to use IM, DLI or a combination of both in a given patient may be difficult.

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