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

Bone Marrow Transplantation volume 37, pages 183–189 (2006)Cite this article

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.

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Acknowledgements

We thank the physicians mentioned in the appendix for referring their patients data to the EBMT Chronic Leukaemia Working Party registry.

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Authors and Affiliations

  1. Bone Marrow Transplantation, University Hospital Hamburg-Eppendorf, Hamburg, Germany

    N Kröger & A Zander

  2. Department of Medical Statistics, Leiden University, Leiden, The Netherlands

    R Brand & A van Biezen

  3. Service d'Hematologie, Hopital Jean Minjoz, Besancon, France

    J-Y Cahn

  4. Department of Bone Marrow Transplantation, Hadassah University Hospital, Jerusalem, Israel

    S Slavin

  5. Institut Paoli Calmettes, Marseille, France

    D Blaise

  6. Department of Hematology, Hospital Santa Creu I Sant Pau, Barcelona, Spain

    J Sierra

  7. Department of Haematology and Oncology, University of Leipzig, Leipzig, Germany

    D Niederwieser

  8. Division of Haematology, University Hospital, Nijmegen, The Netherlands

    T de Witte

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  1. N Kröger
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for the Myelodysplastic Syndromes Subcommittee of The Chronic Leukaemia Working Party of the European Group for Blood and Marrow Transplantation (EBMT)

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Correspondence to N Kröger.

Appendix

Appendix

Table 4 Table a1
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Kröger, N., Brand, R., van Biezen, A. et al. Autologous stem cell transplantation for therapy-related acute myeloid leukemia and myelodysplastic syndrome. Bone Marrow Transplant 37, 183–189 (2006). https://doi.org/10.1038/sj.bmt.1705226

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