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Impact of primary disease on outcome after allogeneic stem cell transplantation for transformed secondary acute leukaemia

Myelodysplastic syndromes (MDS), myeloproliferative neoplasms (MPN) and chronic myelomonocytic leukaemia (CMML) can progress to secondary acute myeloid leukaemia (sAML). We compared the outcome of 4214 sAML patients who received allogeneic haematopoietic stem cell transplantation (allo-HSCT) from an...

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Bibliographic Details
Main Authors: Kröger, Nicolaus (Author) , Schönland, Stefan (Author)
Format: Article (Journal)
Language:English
Published: 28 February 2019
In: British journal of haematology
Year: 2019, Volume: 185, Issue: 4, Pages: 725-732
ISSN:1365-2141
DOI:10.1111/bjh.15819
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1111/bjh.15819
Verlag, lizenzpflichtig, Volltext: https://onlinelibrary.wiley.com/doi/abs/10.1111/bjh.15819
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Author Notes:Nicolaus Kröger, Diderik-Jan Eikema, Linda Köster, Dietrich Beelen, Liesbeth C. de Wreede, Jürgen Finke, Christian Koenecke, Dietger Niederwieser, Martin Bornhäuser, Stefan Schoenland, Victoria Potter, Christine Wolschke, Johan Maertens, Matthias Theobald, Guido Kobbe, Maija Itälä‐Remes, Gerald Wulf, Peter Kahls, Edouard Forcade, Hildegard Greinix, Tamás Masszi, Ibrahim Yakoub‐Agha, Yves Chalandon, Marie Robin and on behalf of the Chronic Malignancies Working Party of the European Society for Blood Marrow Transplantation
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Summary:Myelodysplastic syndromes (MDS), myeloproliferative neoplasms (MPN) and chronic myelomonocytic leukaemia (CMML) can progress to secondary acute myeloid leukaemia (sAML). We compared the outcome of 4214 sAML patients who received allogeneic haematopoietic stem cell transplantation (allo-HSCT) from an unrelated (62%) or human leucocyte antigen (HLA)-identical sibling donor (38%) according the underlying disease: MDS (n = 3541), CMML (n = 251) or MPN (n = 422). After a median follow up of 46·5 months, the estimated 3-year progression-free (PFS) and overall survival (OS) for the entire group was 36% (34-37%) and 41% (40-43%), respectively. The cumulative incidence of relapse and non-relapse mortality (NRM) was 37% (35-39%) and 27% (26-29%), respectively. In a multivariable analysis for OS, besides age (P < 0·001), unrelated donor (P = 0·011), cytomegalovirus ± constellation (P = 0·007), Karnofsky index ≤ 80 (P < 0·001), remission status (P < 0·001), peripheral blood as stem cell source (P = 0·009), sAML from MPN (P = 0·003) remained a significant factor in comparison to sAML from MDS, while worse outcome of sAML from CMML did not reach statistical significance (P = 0·06). This large registry study demonstrates a major impact of the underlying disease on outcome of sAML after allo-HSCT.
Item Description:Gesehen am 27.03.2020
Physical Description:Online Resource
ISSN:1365-2141
DOI:10.1111/bjh.15819

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