Allogeneic stem cell transplantation in therapy-related acute myeloid leukemia and myelodysplastic syndromes: Impact of patient characteristics and timing of transplant

Francesco Spina, Paolo Emilio Alessandrino, Raffaella Milani, Francesca Bonifazi, Massimo Bernardi, Roberto Luksch, Franca Fagioli, Chiara Formica, Lucia Farina

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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.

Original languageEnglish
Pages (from-to)96-102
Number of pages7
JournalLeukemia and Lymphoma
Issue number1
Publication statusPublished - Jan 2012



  • Acute myeloid leukemia
  • Allogeneic stem cell transplantation
  • Myelodysplastic syndromes
  • Therapy-related

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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