Therapy-related acute myeloid leukemia and myelodysplastic syndrome after hematopoietic cell transplantation for lymphoma

S. Yamasaki, R. Suzuki, K. Hatano, K. Fukushima, H. Iida, S. Morishima, Y. Suehiro, T. Fukuda, N. Uchida, H. Uchiyama, H. Ikeda, A. Yokota, K. Tsukasaki, H. Yamaguchi, J. Kuroda, H. Nakamae, Y. Adachi, K. I. Matsuoka, Y. Nakamura, Y. AtsutaJ. Suzumiya

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6 Citations (Scopus)

Abstract

Therapy-related acute myeloid leukemia and myelodysplastic syndrome (t-AML/MDS) represent severe late effects in patients receiving hematopoietic cell transplantation (HCT) for lymphoma. The choice between high-dose therapy with autologous HCT and allogeneic HCT with reduced-intensity conditioning remains controversial in patients with relapsed lymphoma. We retrospectively analyzed incidence and risk factors for the development of t-AML/MDS in lymphoma patients treated with autologous or allogeneic HCT. A total of 13 810 lymphoma patients who received autologous (n=9963) or allogeneic (n=3847) HCT between 1985 and 2012 were considered. At a median overall survival (OS) of 52 and 46 months in autologous and allogeneic HCT groups, respectively, lymphoma patients receiving autologous HCT (1.38% at 3 years after autologous HCT) had a significant risk for developing t-AML/MDS compared to allogeneic HCT (0.37% at 3 years after allogeneic HCT, P<0.001). Significant risk factors for the development of t-AML/MDS after autologous and allogeneic HCT were high-stage risk at HCT (P=0.04) or secondary malignancies (P<0.001) and receiving cord blood stem cell (P=0.03) or involved field radiotherapy (P=0.002), respectively. Strategies that carefully select lymphoma patients for autologous HCT, by excluding lymphoma patients with high-stage risk at HCT, may allow the identification of individual lymphoma patients at particular high risk for t-AML/MDS.

Original languageEnglish
Pages (from-to)969-976
Number of pages8
JournalBone Marrow Transplantation
Volume52
Issue number7
DOIs
Publication statusPublished - Jul 1 2017
Externally publishedYes

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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    Yamasaki, S., Suzuki, R., Hatano, K., Fukushima, K., Iida, H., Morishima, S., Suehiro, Y., Fukuda, T., Uchida, N., Uchiyama, H., Ikeda, H., Yokota, A., Tsukasaki, K., Yamaguchi, H., Kuroda, J., Nakamae, H., Adachi, Y., Matsuoka, K. I., Nakamura, Y., ... Suzumiya, J. (2017). Therapy-related acute myeloid leukemia and myelodysplastic syndrome after hematopoietic cell transplantation for lymphoma. Bone Marrow Transplantation, 52(7), 969-976. https://doi.org/10.1038/bmt.2017.52