Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2010 Mar 4;115(9):1850-7.
doi: 10.1182/blood-2009-10-249128. Epub 2009 Dec 23.

Allogeneic transplantation for therapy-related myelodysplastic syndrome and acute myeloid leukemia

Mark R Litzow  1 , Sergey Tarima, Waleska S Pérez, Brian J Bolwell, Mitchell S Cairo, Bruce M Camitta, Corey S Cutler, Marcos de Lima, John F Dipersio, Robert Peter Gale, Armand Keating, Hillard M Lazarus, Selina Luger, David I Marks, Richard T Maziarz, Philip L McCarthy, Marcelo C Pasquini, Gordon L Phillips, J Douglas Rizzo, Jorge Sierra, Martin S Tallman, Daniel J Weisdorf
Affiliations

Allogeneic transplantation for therapy-related myelodysplastic syndrome and acute myeloid leukemia

Mark R Litzow et al. Blood. .

Abstract

Therapy-related myelodysplastic syndromes (t-MDSs) and acute myeloid leukemia (t-AML) have a poor prognosis with conventional therapy. Encouraging results are reported after allogeneic transplantation. We analyzed outcomes in 868 persons with t-AML (n = 545) or t-MDS (n = 323) receiving allogeneic transplants from 1990 to 2004. A myeloablative regimen was used for conditioning in 77%. Treatment-related mortality (TRM) and relapse were 41% (95% confidence interval [CI], 38-44) and 27% (24-30) at 1 year and 48% (44-51) and 31% (28-34) at 5 years, respectively. Disease-free (DFS) and overall survival (OS) were 32% (95% CI, 29-36) and 37% (34-41) at 1 year and 21% (18-24) and 22% (19-26) at 5 years, respectively. In multivariate analysis, 4 risk factors had adverse impacts on DFS and OS: (1) age older than 35 years; (2) poor-risk cytogenetics; (3) t-AML not in remission or advanced t-MDS; and (4) donor other than an HLA-identical sibling or a partially or well-matched unrelated donor. Five-year survival for subjects with none, 1, 2, 3, or 4 of these risk factors was 50% (95% CI, 38-61), 26% (20-31), 21% (16-26), 10% (5-15), and 4% (0-16), respectively (P < .001). These data permit a more precise prediction of outcome and identify subjects most likely to benefit from allogeneic transplantation.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Cumulative incidence of treatment-related mortality by disease status at transplantation after allogeneic hematopoietic cell transplantation (HCT) for therapy-related acute myeloid leukemia (AML) and myelodysplactic syndrome (MDS).
Figure 2
Figure 2
Cumulative incidence of relapse by disease status at transplantation after allogeneic HCT for therapy-related AML and MDS.
Figure 3
Figure 3
Probability of survival. (A) Disease-free survival by disease status at transplantation, (B) leukemia-free survival by type of donor, and (C) overall survival by disease status at transplantation after allogeneic HCT for therapy-related AML and MDS.
Figure 4
Figure 4
Probability of overall survival after allogeneic HCT for therapy-related AML and MDS, by risk factors.
See this image and copyright information in PMC

Comment in

References

    1. Borthakur G, Estey AE. Therapy-related acute myelogenous leukemia and myelodysplastic syndrome. Curr Oncol Rep. 2007;9(5):373–377. - PubMed
    1. Michels SD, McKenna RW, Arthur DC, Brunning RD. Therapy-related acute myeloid leukemia and myelodysplastic syndrome: a clinical and morphologic study of 65 cases. Blood. 1985;65(6):1364–1372. - PubMed
    1. Armand P, Kim HT, DeAngelo DJ, et al. Impact of cytogenetics on outcome of de novo and therapy-related AML and MDS after allogeneic transplantation. Biol Blood Marrow Transplant. 2007;13(6):655–664. - PMC - PubMed
    1. Miller JS, Arthur DC, Litz CE, Neglia JP, Miller WJ, Weisdorf DJ. Myelodysplastic syndrome after autologous bone marrow transplantation: an additional late complication of curative cancer therapy. Blood. 1994;83(12):3780–3786. - PubMed
    1. Stone RM, Neuberg D, Soiffer R, et al. Myelodysplastic syndrome as a late complication following autologous bone marrow transplantation for non-Hodgkin's lymphoma. J Clin Oncol. 1994;12(12):2535–2542. - PubMed

Publication types

MeSH terms