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Long-term survival benefit after allogeneic hematopoietic cell transplantation for chronic myelomonocytic leukemia

The critical question in the management of chronic myelomonocytic leukemia (CMML) is which patients may benefit from allogeneic hematopoietic cell transplantation (allo-HCT). Using ad hoc statistical analysis, we designed a multicenter retrospective study to determine outcomes in 261 patients age &l...

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Main Authors: Gagelmann, Nico (Author) , Bogdanov, Rashit (Author) , Stoelzel, Friedrich (Author) , Rautenberg, Christina (Author) , Panagiota, Victoria (Author) , Becker, Heiko (Author) , Radujković, Aleksandar (Author) , Luft, Thomas (Author) , Christopeit, Maximilian Erich Joachim (Author) , Finke, Jürgen (Author) , Platzbecker, Uwe (Author) , Ditschkowski, Markus (Author) , Schroeder, Thomas (Author) , Koldehoff, Michael (Author) , Heuser, Michael (Author) , Kobbe, Guido (Author) , Beelen, Dietrich W. (Author) , Germing, Ulrich (Author) , Kroeger, Nicolaus (Author)
Format: Article (Journal)
Language:English
Published: January 2021
In: Transplantation and cellular therapy
Year: 2021, Volume: 27, Issue: 1, Pages: 95.e1-95.e4
ISSN:2666-6367
DOI:10.1016/j.bbmt.2020.10.007
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.bbmt.2020.10.007
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Author Notes:Nico Gagelmann, Rashit Bogdanov, Friedrich Stoelzel, Christina Rautenberg, Victoria Panagiota, Heiko Becker, Aleksandar Radujkovic, Thomas Luft, Maximilian Christopeit, Jurgen Finke, Uwe Platzbecker, Markus Ditschkowski, Thomas Schroeder, Michael Koldehoff, Michael Heuser, Guido Kobbe, Dietrich W. Beelen, Ulrich Germing, Nicolaus Kroeger
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Summary:The critical question in the management of chronic myelomonocytic leukemia (CMML) is which patients may benefit from allogeneic hematopoietic cell transplantation (allo-HCT). Using ad hoc statistical analysis, we designed a multicenter retrospective study to determine outcomes in 261 patients age <= 70 years at diagnosis who underwent allo-HCT (n = 119) compared with those who did not (n = 142) according to the current CMML-specific prognostic scoring system (CPSS). Categorizing patients as lower risk (CPSS low/intermediate-1) or higher risk (intermediate-2/high) showed significantly improved outcomes after transplantation in higher-risk patients, with a 37% reduced hazard for death. However, although higher CPSS was associated with worse outcomes in the non-transplantation group, the score was of limited utility for post-transplantation risk stratification. This study may provide further support for the potentially beneficial role of allo-HCT in terms of long-term survival in higher-risk patients but also underscores the need for transplantation-specific risk assessment. Recognizing limitations of retrospective comparisons, larger and prospective comparisons are needed to further refine the indication for allo-HCT and thus counseling of patients with CMML. (C) 2020 The American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc. All rights reserved.
Item Description:Gesehen am 03.12.2021
Physical Description:Online Resource
ISSN:2666-6367
DOI:10.1016/j.bbmt.2020.10.007

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