Chronic myeloid leukemia(CML) is a myeloproliferative disease which leads the unregulated growth of myeloid cells in the bone marrow. It is characterized by the presence of Philadelphia chromosome. Reciprocal transloc...Chronic myeloid leukemia(CML) is a myeloproliferative disease which leads the unregulated growth of myeloid cells in the bone marrow. It is characterized by the presence of Philadelphia chromosome. Reciprocal translocation of the ABL gene from chromosome 9 to 22 t(9; 22)(q34; q11.2) generate a fusion gene(BCRABL). BCR-ABL protein had constitutive tyrosine kinase activity that is a primary cause of chronic phase of CML. Tyrosine kinase inhibitors(TKIs) are now considered standard therapy for patients with CML. Even though, successful treatment with the TKIs, allogeneic stem cell transplantation(ASCT) is still an important option for the treatment of CML, especially for patients who are resistant or intolerant to at least one second generation TKI or for patients with blastic phase. Today, we know that there is no evidence for increased transplantrelated toxicity and negative impact of survival with pretransplant TKIs. However, there are some controversies about timing of ASCT, the optimal conditioning regimens and donor source. Another important issue is that BCRABL signaling is not necessary for survival of CML stem cell and TKIs were not effective on these cells. So, ASCT may play a role to eliminate CML stem cells. In this article, we review the diagnosis, management and treatment of CML. Later, we present our center's outcomes of ASCT for patients with CML and then, we discuss the place of ASCT in CML treatment in the TKIs era.展开更多
Bone marrow microenvironment (BMM) is the main sanctuary of leukemic stem cells (LSCs) and protects these cells against conventional therapies. However, it may open up an opportunity to target LSCs by breaking the clo...Bone marrow microenvironment (BMM) is the main sanctuary of leukemic stem cells (LSCs) and protects these cells against conventional therapies. However, it may open up an opportunity to target LSCs by breaking the close connection between LSCs and the BMM. The elimination of LSCs is of high importance, since they follow cancer stem cell theory as a part of this population. Based on cancer stem cell theory, a cell with stem cell-like features stands at the apex of the hierarchy and produces a heterogeneous population and governs the disease. Secretion of cytokines, chemokines, and extracellular vesicles, whether through autocrine or paracrine mechanisms by activation of downstream signaling pathways in LSCs, favors their persistence and makes the BMM less hospitable for normal stem cells. While all details about the interactions of the BMM and LSCs remain to be elucidated, some clinical trials have been designed to limit these reciprocal interactions to cure leukemia more effectively. In this review, we focus on chronic myeloid leukemia and acute myeloid leukemia LSCs and their milieu in the bone marrow, how to segregate them from the normal compartment, and finally the possible ways to eliminate these cells.展开更多
Chronic myeloid leukemia （CML） is a clonal myeloprolif- erative disorder characterized by a chromosome translocation that generates the Bcr-Abl oncogene en- coding a constitutive kinase activity. Despite remarkable ...Chronic myeloid leukemia （CML） is a clonal myeloprolif- erative disorder characterized by a chromosome translocation that generates the Bcr-Abl oncogene en- coding a constitutive kinase activity. Despite remarkable success in controlling CML at chronic phase by Bcr-Abl tyrosine kinase inhibitors （TKIs）, a significant proportion of CML patients treated with TKIs develop drug resis- tance due to the inability of TKIs to kill leukemia stem cells （LSCs） that are responsible for initiation, drug re- sistance, and relapse of CML. Therefore, there is an ur- gent need for more potent and safer therapies against leukemia stem cells for curing CML. A number of LSC- associated targets and corresponding signaling path- ways, including CaMKII-y, a critical molecular switch for co-activating mu｜tipte LSC-associated signaling path- ways, have been identified over the past decades and various small inhibitors targeting LSC are also under development. Increasing evidence shows that leukemia stem cells are the root of CML and targeting LSC may offer a curable treatment option for CML patients. This review summarizes the molecular biology of LSC and its- associated targets, and the potential clinical application in chronic myeloid leukemia.展开更多
Objective：To investigate the effects of quercetin on Hedgehog（Hh） signaling in chronic myeloid leukemia KBM7 cells.Methods：The KBM7 cells were treated with 50,100 and 200 μmol/L quercetin for48 h respectively.And...Objective：To investigate the effects of quercetin on Hedgehog（Hh） signaling in chronic myeloid leukemia KBM7 cells.Methods：The KBM7 cells were treated with 50,100 and 200 μmol/L quercetin for48 h respectively.And then the trypan blue assay was used to examine the proliferative inhibition of quercetin.Apoptotic cells and cell cycle were measured by flow cytometry.The mRNA and protein expression were detected by quantitative real-time polymerase chain reaction（PCR） and Western blot,respectively.Results：Quercetin significantly inhibited KBM7 cell proliferation,induced cell apoptosis,and blocked cell cycle at G1 phase,which were in dose-dependent manners.The mRNA and protein expression of Smoothened and Gliomal（Gli1）,the members of Hh pathway decreased after treatment with quercetin.The Bcl-2 and Cyclin D1,targets of Hh signaling,also decreased after treatment with quercetin,respectively.Quercetin also could increase p53 and Caspase-3 expression.Bcr-abl mRNA copies decreased,but no changes of phosphorylated Bcr-abl and Bcr-abl proteins were observed,after treatment with quercetin.Conclusion：Quercetin could inhibit Hh signaling and its downstream targets in the KBM7 cells.And it might be one of mechanisms of inducing apoptosis and inhibiting cell cycle by quercetin.展开更多
Background Overwhelming evidences on chronic myeloid leukemia （CML） indicate that patients harbor quiescent CML stem cells that are responsible for blast crisis. While the hematopoietic stem cell （HSC） origin of C...Background Overwhelming evidences on chronic myeloid leukemia （CML） indicate that patients harbor quiescent CML stem cells that are responsible for blast crisis. While the hematopoietic stem cell （HSC） origin of CML was first suggested over 30 years ago, recently CML-initiating cells beyond HSCs are also being investigated. Methods We have previously isolated fetal liver kinase-l-positive （Flkl＋） cells carrying the BCR/ABL fusion gene from the bone marrow of Ph＋ patients with hemangioblast property. In this study, we isolated CML patient-derived FIk1＋CD31-CD34- mesenchymal stem cells （MSCs） and detected their biological characteristics and immunological regulation using fluorescence in situ hybridization （FISH） analysis, fluorescence activated cell sorting （FACS）, enzyme-linked immunoadsorbent assay, mixed lymphocyte reaction assays; then we compared these characters with those of the healthy donors. Results CML patient-derived FIk1＋CD31-CD34- MSCs had normal morphology, phenotype and karyotype while appeared impaired in immuno-modulatory function. The capacity of patient FIk1＋CD31-CD34- MSCs to inhibit T lymphocyte activation and proliferation was impaired in vitro. Conclusions CML patient-derived MSCs have impaired immuno-modulatory functions, suggesting that the dysregulation of hematopoiesis and immune response may originate from MSCs rather than hematopoietic stem cells （HSCs）. MSCs might be a potential target for developing efficacious treatment for CML.展开更多
The approval of imatinib in 2001 has changed the landscape of CML management.^-3 With its excellent efficacy in the International Interferon and STI571 （IRIS）, Randomized Study of imatinib has become the standard o...The approval of imatinib in 2001 has changed the landscape of CML management.^-3 With its excellent efficacy in the International Interferon and STI571 （IRIS）, Randomized Study of imatinib has become the standard of care for newly diagnosed patients. This change challenges the previous role of allogeneic hematopoietic stem cell transplantation （allo-HSCT） in CML treatment. However,展开更多
Background The role of Wilms＇ tumor 1 protein （WT1）-specific cytotoxic T cells （CTL） in eradicating chronic myeloid leukemia （CML） cells is to be established. The aim of this study was to determine whether WT1 ...Background The role of Wilms＇ tumor 1 protein （WT1）-specific cytotoxic T cells （CTL） in eradicating chronic myeloid leukemia （CML） cells is to be established. The aim of this study was to determine whether WT1 contributed to the graft-versus-leukemia effects （GVLE） for CML following allogeneic hematopoietic stem cell transplantation （HSCT）. Methods High-resolution human leukocyte antigen （HLA） class I genotyping was performed by sequence-specific polymerase chain reaction （PCR）. Fifteen HLA-A~＊2402 patients with CML who underwent allogeneic HSCT were enrolled in this study. We monitored the frequency of WT1-specific CTL by pentamer assay and the molecular minimal residual disease by real-time quantitative PCR.Results A CD8＋ T-cell response to WT1 was observed in 14 of 15 patients after HSCT. The median frequencies of WT1-CTL were 0.54%, 0.62%, 0.81% and 1.28% （%CD8） on days 30, 60, 90 and 180, respectively. The median frequency of WT1-CTL （1.38%） in patients with molecular remission （MoR） was significantly higher than that in those without MoR （0.38%） on day 30, while no significant differences between them were detected on days 60, 90 and 180. The increase of WT1-CTL was associated with a decrease in bcr-abl expression and MoR; and the decrease of WT1-CTL was associated with an increase in bcr-abl expression, suggesting a WT1 -driven GVL effect. WT1-CTL had a predominant effector-memory phenotype （CD45RO＋CD27-CD57＋）.Conclusions The emergence of WT1-CTL with an effector-memory phenotype is associated with GVLE in CML patients after HSCT. This will pave the way for the WT1 vaccines to enhance GVLE after HSCT in CML.展开更多
Objective To evaluate the function of T cells in chronic myeloid leukemia (CML) Methods Interleukin 1β (IL 1β), interleukin 2 (IL 2), interleukin 3 (IL 3), interleukin 4 (IL 4), interleukin 6 (IL 6), t...Objective To evaluate the function of T cells in chronic myeloid leukemia (CML) Methods Interleukin 1β (IL 1β), interleukin 2 (IL 2), interleukin 3 (IL 3), interleukin 4 (IL 4), interleukin 6 (IL 6), tumor necrosis factor alpha(TNFα), and granulocyte macrophage colony stimulating factor (GM CSF) gene expressions were investigated by reverse transcription polymerase chain reaction (RT PCR) assay in fluorescence active cell sorter (FACS) sorted peripheral blood CD2+/CD56 T cells from 12 CML patients, 10 meylodysplastic syndrome (MDS) patients and 7 normal individuals Results TNFα mRNA was transcribed in T cells from all of the CML, MDS and normal individuals IL 1β mRNA was transcribed in T cells from 10 CML, 9 MDS and 6 normal individuals Low levels of IL 2 and IL 4 mRNA were detected in 5 CML patients IL 3, IL 6 and GM CSF mRNA were undetectable in all samples Conclusion IL 4 and IL 2 were expressed abnormally in T cells of CML展开更多
In the tyrosine kinase inhibitor （TKI） era, imatinib is the first-line therapy for patients with chronic myeloid leukemia （CML） in chronic or accelerated phase. Although second-generation TKIs （TKI2）, including ...In the tyrosine kinase inhibitor （TKI） era, imatinib is the first-line therapy for patients with chronic myeloid leukemia （CML） in chronic or accelerated phase. Although second-generation TKIs （TKI2）, including dasatinib and nilotinib, are appropriate treatment regimens for patients with disease that progressed to accelerated phase following imatinib therapy, allogeneic hematopoietic stem cell transplantation （allo-HSCT） is the only curative therapy. This study retrospectively analyzed the efficacy of TKI2 and HSCT for treatment of CML in accelerated phase. Ninety-three patients with CML registered in the Chinese CML alliance database from February 2001 to February 2014 were enrolled and divided into the TKI2 （n = 33） and allo-HSCT （n = 60） groups. In the TKI2 group, 26 and 7 patients received nilotinib and dasatinib, respectively, as initial TKI2 and 11 patients transferred to the alternative TKI2 after failure to one TKI2. In the allo-HSCT group, 22 （36.7%）, 35 （58.3%）, and 3 （10%） patients underwent aHo-HSCT from an HLA-matched sibling donor, HLA mismatched/haploidentical donor, and unrelated donor, respectively. All patients in the HSCT group were engrafted. Overall, 69.7%, 48.5%, and 45.5% of patients presented hematological, cytogenetic, and major molecular responses, respectively, to at least one of TKI2. All 60 patients （100%） achieved CHR and cytogenetic response in the HSCT group. Patients in the TKI2 group exhibited lower 5-year overall survival rate （42.9% vs. 86.4%, P = 0.002）, 5-year event-free survival rate （14.3% vs. 76.1%, P 〈 0.001）, and 5-year progression-free survival （28.6% vs. 78.1%, P 〈 0.001） than those in the alIo-HSCT group. Multivariate analysis showed that male sex and TKI2 therapy were predictors of poor overall survival, whereas hemoglobin 〈 100 g/L and TKI2 therapy were predictors of poor event-free survival and progression-free survival. These results indicated that allo-HSCT may be superior to nilotinib and dasatinib for adult patients with CML in accelerated phase.展开更多
文摘Chronic myeloid leukemia(CML) is a myeloproliferative disease which leads the unregulated growth of myeloid cells in the bone marrow. It is characterized by the presence of Philadelphia chromosome. Reciprocal translocation of the ABL gene from chromosome 9 to 22 t(9; 22)(q34; q11.2) generate a fusion gene(BCRABL). BCR-ABL protein had constitutive tyrosine kinase activity that is a primary cause of chronic phase of CML. Tyrosine kinase inhibitors(TKIs) are now considered standard therapy for patients with CML. Even though, successful treatment with the TKIs, allogeneic stem cell transplantation(ASCT) is still an important option for the treatment of CML, especially for patients who are resistant or intolerant to at least one second generation TKI or for patients with blastic phase. Today, we know that there is no evidence for increased transplantrelated toxicity and negative impact of survival with pretransplant TKIs. However, there are some controversies about timing of ASCT, the optimal conditioning regimens and donor source. Another important issue is that BCRABL signaling is not necessary for survival of CML stem cell and TKIs were not effective on these cells. So, ASCT may play a role to eliminate CML stem cells. In this article, we review the diagnosis, management and treatment of CML. Later, we present our center's outcomes of ASCT for patients with CML and then, we discuss the place of ASCT in CML treatment in the TKIs era.
文摘Bone marrow microenvironment (BMM) is the main sanctuary of leukemic stem cells (LSCs) and protects these cells against conventional therapies. However, it may open up an opportunity to target LSCs by breaking the close connection between LSCs and the BMM. The elimination of LSCs is of high importance, since they follow cancer stem cell theory as a part of this population. Based on cancer stem cell theory, a cell with stem cell-like features stands at the apex of the hierarchy and produces a heterogeneous population and governs the disease. Secretion of cytokines, chemokines, and extracellular vesicles, whether through autocrine or paracrine mechanisms by activation of downstream signaling pathways in LSCs, favors their persistence and makes the BMM less hospitable for normal stem cells. While all details about the interactions of the BMM and LSCs remain to be elucidated, some clinical trials have been designed to limit these reciprocal interactions to cure leukemia more effectively. In this review, we focus on chronic myeloid leukemia and acute myeloid leukemia LSCs and their milieu in the bone marrow, how to segregate them from the normal compartment, and finally the possible ways to eliminate these cells.
基金We apologize to the scientists who made contributions to the field, but have not been cited due to the space limitations. This work was sup- ported in part by the National Natural Science Foundation of China （Grant Nos. 81270601, 81328016, and 81470306） and Leukemia Research Innovative Team of Zhejiang Province （2011 R50015）.
文摘Chronic myeloid leukemia （CML） is a clonal myeloprolif- erative disorder characterized by a chromosome translocation that generates the Bcr-Abl oncogene en- coding a constitutive kinase activity. Despite remarkable success in controlling CML at chronic phase by Bcr-Abl tyrosine kinase inhibitors （TKIs）, a significant proportion of CML patients treated with TKIs develop drug resis- tance due to the inability of TKIs to kill leukemia stem cells （LSCs） that are responsible for initiation, drug re- sistance, and relapse of CML. Therefore, there is an ur- gent need for more potent and safer therapies against leukemia stem cells for curing CML. A number of LSC- associated targets and corresponding signaling path- ways, including CaMKII-y, a critical molecular switch for co-activating mu｜tipte LSC-associated signaling path- ways, have been identified over the past decades and various small inhibitors targeting LSC are also under development. Increasing evidence shows that leukemia stem cells are the root of CML and targeting LSC may offer a curable treatment option for CML patients. This review summarizes the molecular biology of LSC and its- associated targets, and the potential clinical application in chronic myeloid leukemia.
基金Supported by grants of Heilongjiang Health Bureau Technology Project(No.2011-520)Harbin Technology Research Fund(No.2012RFQYS073)
文摘Objective：To investigate the effects of quercetin on Hedgehog（Hh） signaling in chronic myeloid leukemia KBM7 cells.Methods：The KBM7 cells were treated with 50,100 and 200 μmol/L quercetin for48 h respectively.And then the trypan blue assay was used to examine the proliferative inhibition of quercetin.Apoptotic cells and cell cycle were measured by flow cytometry.The mRNA and protein expression were detected by quantitative real-time polymerase chain reaction（PCR） and Western blot,respectively.Results：Quercetin significantly inhibited KBM7 cell proliferation,induced cell apoptosis,and blocked cell cycle at G1 phase,which were in dose-dependent manners.The mRNA and protein expression of Smoothened and Gliomal（Gli1）,the members of Hh pathway decreased after treatment with quercetin.The Bcl-2 and Cyclin D1,targets of Hh signaling,also decreased after treatment with quercetin,respectively.Quercetin also could increase p53 and Caspase-3 expression.Bcr-abl mRNA copies decreased,but no changes of phosphorylated Bcr-abl and Bcr-abl proteins were observed,after treatment with quercetin.Conclusion：Quercetin could inhibit Hh signaling and its downstream targets in the KBM7 cells.And it might be one of mechanisms of inducing apoptosis and inhibiting cell cycle by quercetin.
文摘Background Overwhelming evidences on chronic myeloid leukemia （CML） indicate that patients harbor quiescent CML stem cells that are responsible for blast crisis. While the hematopoietic stem cell （HSC） origin of CML was first suggested over 30 years ago, recently CML-initiating cells beyond HSCs are also being investigated. Methods We have previously isolated fetal liver kinase-l-positive （Flkl＋） cells carrying the BCR/ABL fusion gene from the bone marrow of Ph＋ patients with hemangioblast property. In this study, we isolated CML patient-derived FIk1＋CD31-CD34- mesenchymal stem cells （MSCs） and detected their biological characteristics and immunological regulation using fluorescence in situ hybridization （FISH） analysis, fluorescence activated cell sorting （FACS）, enzyme-linked immunoadsorbent assay, mixed lymphocyte reaction assays; then we compared these characters with those of the healthy donors. Results CML patient-derived FIk1＋CD31-CD34- MSCs had normal morphology, phenotype and karyotype while appeared impaired in immuno-modulatory function. The capacity of patient FIk1＋CD31-CD34- MSCs to inhibit T lymphocyte activation and proliferation was impaired in vitro. Conclusions CML patient-derived MSCs have impaired immuno-modulatory functions, suggesting that the dysregulation of hematopoiesis and immune response may originate from MSCs rather than hematopoietic stem cells （HSCs）. MSCs might be a potential target for developing efficacious treatment for CML.
基金This work was supported （in part） by the grants from the National Outstanding Young Scientist＇s Foundation of China （No. 30725038）, the National Natural Science Foundation of China （No. 30971292）, and the Leading Program of Clinical Faculty accredited by the Ministry of Health of China.
文摘The approval of imatinib in 2001 has changed the landscape of CML management.^-3 With its excellent efficacy in the International Interferon and STI571 （IRIS）, Randomized Study of imatinib has become the standard of care for newly diagnosed patients. This change challenges the previous role of allogeneic hematopoietic stem cell transplantation （allo-HSCT） in CML treatment. However,
基金This work was supported by the grants from the Outstanding Youth Fund of Natural Science Foundation （No. 30725038）, National 863 Hi-tech Project （No. IRT0702）, Invocation Team Fund （No. 2006AA02Z4A0） and the Ph.D. Programs Foundation of Ministry of Education of China （No. 20060001108）.
文摘Background The role of Wilms＇ tumor 1 protein （WT1）-specific cytotoxic T cells （CTL） in eradicating chronic myeloid leukemia （CML） cells is to be established. The aim of this study was to determine whether WT1 contributed to the graft-versus-leukemia effects （GVLE） for CML following allogeneic hematopoietic stem cell transplantation （HSCT）. Methods High-resolution human leukocyte antigen （HLA） class I genotyping was performed by sequence-specific polymerase chain reaction （PCR）. Fifteen HLA-A~＊2402 patients with CML who underwent allogeneic HSCT were enrolled in this study. We monitored the frequency of WT1-specific CTL by pentamer assay and the molecular minimal residual disease by real-time quantitative PCR.Results A CD8＋ T-cell response to WT1 was observed in 14 of 15 patients after HSCT. The median frequencies of WT1-CTL were 0.54%, 0.62%, 0.81% and 1.28% （%CD8） on days 30, 60, 90 and 180, respectively. The median frequency of WT1-CTL （1.38%） in patients with molecular remission （MoR） was significantly higher than that in those without MoR （0.38%） on day 30, while no significant differences between them were detected on days 60, 90 and 180. The increase of WT1-CTL was associated with a decrease in bcr-abl expression and MoR; and the decrease of WT1-CTL was associated with an increase in bcr-abl expression, suggesting a WT1 -driven GVL effect. WT1-CTL had a predominant effector-memory phenotype （CD45RO＋CD27-CD57＋）.Conclusions The emergence of WT1-CTL with an effector-memory phenotype is associated with GVLE in CML patients after HSCT. This will pave the way for the WT1 vaccines to enhance GVLE after HSCT in CML.
文摘Objective To evaluate the function of T cells in chronic myeloid leukemia (CML) Methods Interleukin 1β (IL 1β), interleukin 2 (IL 2), interleukin 3 (IL 3), interleukin 4 (IL 4), interleukin 6 (IL 6), tumor necrosis factor alpha(TNFα), and granulocyte macrophage colony stimulating factor (GM CSF) gene expressions were investigated by reverse transcription polymerase chain reaction (RT PCR) assay in fluorescence active cell sorter (FACS) sorted peripheral blood CD2+/CD56 T cells from 12 CML patients, 10 meylodysplastic syndrome (MDS) patients and 7 normal individuals Results TNFα mRNA was transcribed in T cells from all of the CML, MDS and normal individuals IL 1β mRNA was transcribed in T cells from 10 CML, 9 MDS and 6 normal individuals Low levels of IL 2 and IL 4 mRNA were detected in 5 CML patients IL 3, IL 6 and GM CSF mRNA were undetectable in all samples Conclusion IL 4 and IL 2 were expressed abnormally in T cells of CML
基金Acknowledgements The Chinese CML alliance provided the data. This work was partly supported by grants from the Collaborative Innovation Center of Hematology in China, the Key Program of the National Natural Science Foundation of China （81230013）, and the Beijing Municipal Science and Technology Commission （Nos. Z121107002812033 and Z121107002612035）.
文摘In the tyrosine kinase inhibitor （TKI） era, imatinib is the first-line therapy for patients with chronic myeloid leukemia （CML） in chronic or accelerated phase. Although second-generation TKIs （TKI2）, including dasatinib and nilotinib, are appropriate treatment regimens for patients with disease that progressed to accelerated phase following imatinib therapy, allogeneic hematopoietic stem cell transplantation （allo-HSCT） is the only curative therapy. This study retrospectively analyzed the efficacy of TKI2 and HSCT for treatment of CML in accelerated phase. Ninety-three patients with CML registered in the Chinese CML alliance database from February 2001 to February 2014 were enrolled and divided into the TKI2 （n = 33） and allo-HSCT （n = 60） groups. In the TKI2 group, 26 and 7 patients received nilotinib and dasatinib, respectively, as initial TKI2 and 11 patients transferred to the alternative TKI2 after failure to one TKI2. In the allo-HSCT group, 22 （36.7%）, 35 （58.3%）, and 3 （10%） patients underwent aHo-HSCT from an HLA-matched sibling donor, HLA mismatched/haploidentical donor, and unrelated donor, respectively. All patients in the HSCT group were engrafted. Overall, 69.7%, 48.5%, and 45.5% of patients presented hematological, cytogenetic, and major molecular responses, respectively, to at least one of TKI2. All 60 patients （100%） achieved CHR and cytogenetic response in the HSCT group. Patients in the TKI2 group exhibited lower 5-year overall survival rate （42.9% vs. 86.4%, P = 0.002）, 5-year event-free survival rate （14.3% vs. 76.1%, P 〈 0.001）, and 5-year progression-free survival （28.6% vs. 78.1%, P 〈 0.001） than those in the alIo-HSCT group. Multivariate analysis showed that male sex and TKI2 therapy were predictors of poor overall survival, whereas hemoglobin 〈 100 g/L and TKI2 therapy were predictors of poor event-free survival and progression-free survival. These results indicated that allo-HSCT may be superior to nilotinib and dasatinib for adult patients with CML in accelerated phase.
