Autologous stem cell transplantation for therapy-related acute myeloid leukemia and myelodysplastic syndrome

N. Kröger, R. Brand, A. van Biezen, J. Y. Cahn, S. Slavin, D. Blaise, J. Sierra, A. Zander, D. Niederwieser, T. de Witte, A. Ferrant, C. Messina, N. Narhalakis, M. Björkholm, V. Castel, M. Michallet, A. Gratwohl, R. Barge, C. Heilmann, M. BoogaertsP. Ljungman, L. Douay, E. Carreras, B. Rio, W. Arcese, A. Iriondo, D. Guyotat, C. Cordonnier, D. Beelen, J. Reiffers, G. Dini, M. Brune, G. Leone, R. Schwerdtfeger, J. D. González San Miguel, M. R. Schaafsma, N. Gratecos, A. D. Ho, A. M. Carella, M. Janvier, R. Marcus, M. Freund, G. Ossenkoppele, R. Lasa Isasti, R. Schots, M. Boasson, J. Briere, M. Sanz, H. Guy, G. Mufti, J. M. Rodríguez Fernández, A. Hellmann, J. Vannier

Research output: Contribution to journalArticlepeer-review

Abstract

We report the results of 65 patients with treatment-related myelodysplastic syndrome (MDS)/acute myelogenous leukemia (AML) who were transplanted from an autograft and reported to the EBMT. The median age was 39 years (range, 3-69), and stem cell source was bone marrow (n = 31), or peripheral blood progenitor cells (n = 30), or the combination of both (n = 4). The primary disease was solid tumors (n = 37), Hodgkin's disease (n = 13), non-Hodgkin's lymphoma (n = 10), acute lymphoblastic leukemia (n = 2) or myeloproliferative syndromes (n = 3). The types of MDS were as follows: RAEB (n = 1; 2%), RAEB-t (n = 3; 5%), or AML (n = 56; 87%). The median time between diagnosis and transplantation was 5 months (range, 3-86). The Kaplan -Meier estimates of the probability of 3-year overall and disease-free survival were 35% (95% CI: 21-49%) and 32% (95% CI: 18-45%), respectively. The median leukocyte engraftment was faster after transplantation with peripheral blood stem cells than with bone marrow: 12 (range, 9-26) vs 29 (range, 11-67) days (P <0.001). The cumulative incidence of relapse was 58% (95% CI: 44-72%) and of treatment-related mortality 12% (95% CI: 6-38%). Lower relapse rate was seen in patients transplanted in first complete remission (CR1 vs non-CR1: 3 years: 48 vs 89%; P = 0.05). Furthermore, age beyond 40 years resulted in a higher treatment-related mortality (47 vs 7%; P = 0.01). In a multivariate analysis, transplantation in CR1 age as well as their interaction influenced overall survival significantly. Autologous transplantation may cure a substantial number of patients with treatment-related MDS/AML, especially if they are in CR1 and of younger age.

Original languageEnglish
Pages (from-to)183-189
Number of pages7
JournalBone Marrow Transplantation
Volume37
Issue number2
DOIs
Publication statusPublished - Jan 2006

Keywords

  • Acute myelogenous leukemia
  • Autologous stem cell transplantation
  • Myelodysplastic syndrome
  • Therapy-related

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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