TY - JOUR
T1 - Allogeneic stem cell transplantation in therapy-related acute myeloid leukemia and myelodysplastic syndromes
T2 - Impact of patient characteristics and timing of transplant
AU - Spina, Francesco
AU - Alessandrino, Paolo Emilio
AU - Milani, Raffaella
AU - Bonifazi, Francesca
AU - Bernardi, Massimo
AU - Luksch, Roberto
AU - Fagioli, Franca
AU - Formica, Chiara
AU - Farina, Lucia
PY - 2012/1
Y1 - 2012/1
N2 - Patients with therapy-related acute myeloid leukemia (t-AML) and myelodysplastic syndromes (t-MDS) have poor survival and high non-relapse mortality (NRM) after allogeneic stem cell transplantation. This retrospective study assessed the transplant outcomes of 29 consecutive patients with t-AML (83%) or t-MDS (17%) treated with allogeneic transplantation. The median age of patients was 51 years. Donors were mostly matched unrelated (52%), and 59% of patients received myeloablative conditioning. Two-year overall survival, event-free survival and relapse incidence were 37%, 34% and 33%; NRM was 17% at 100 days, and 32% at 2 years. Event-free survival was reduced in patients with high-risk cytogenetics (p = 0.02), Karnofsky performance status ≤ 80% (p = 0.001) and disease after induction ± consolidation (p = 0.006). NRM was higher in patients receiving > 2 therapy lines for previous cancer (p = 0.01) and in those allografted > 6 months from diagnosis (p = 0.03). In conclusion, allogeneic transplantation should be proposed timely to these patients after an accurate analysis of patient history.
AB - Patients with therapy-related acute myeloid leukemia (t-AML) and myelodysplastic syndromes (t-MDS) have poor survival and high non-relapse mortality (NRM) after allogeneic stem cell transplantation. This retrospective study assessed the transplant outcomes of 29 consecutive patients with t-AML (83%) or t-MDS (17%) treated with allogeneic transplantation. The median age of patients was 51 years. Donors were mostly matched unrelated (52%), and 59% of patients received myeloablative conditioning. Two-year overall survival, event-free survival and relapse incidence were 37%, 34% and 33%; NRM was 17% at 100 days, and 32% at 2 years. Event-free survival was reduced in patients with high-risk cytogenetics (p = 0.02), Karnofsky performance status ≤ 80% (p = 0.001) and disease after induction ± consolidation (p = 0.006). NRM was higher in patients receiving > 2 therapy lines for previous cancer (p = 0.01) and in those allografted > 6 months from diagnosis (p = 0.03). In conclusion, allogeneic transplantation should be proposed timely to these patients after an accurate analysis of patient history.
KW - Acute myeloid leukemia
KW - Allogeneic stem cell transplantation
KW - Myelodysplastic syndromes
KW - Therapy-related
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U2 - 10.3109/10428194.2011.603445
DO - 10.3109/10428194.2011.603445
M3 - Article
C2 - 21740299
AN - SCOPUS:84855422191
VL - 53
SP - 96
EP - 102
JO - Leukemia and Lymphoma
JF - Leukemia and Lymphoma
SN - 1042-8194
IS - 1
ER -