PURPOSE: The absolute risk of myelodysplastic syndrome (MDS) after autologous bone marrow transplant (ABMT) for non-Hodgkin's lymphoma (NHL) exceeds 5% in several reported series. We report the outcome of a large cohort of patients who developed MDS after ABMT for NHL. PATIENTS AND METHODS: Between December 1982 and December 1997, 552 patients underwent ABMT for NHL, with a uniform ablative regimen of cyclophosphamide and total body irradiation followed by reinfusion of obtained marrow purged with monoclonal antibodies. MDS was strictly defined, using the French-American-British classification system, as requiring bone marrow dysplasia in at least two cell lines, with associated unexplained persistent cytopenias. RESULTS: Forty-one patients developed MDS at a median of 47 months after ABMT. The incidence of MDS was 7.4%, and actuarial incidence at 10 years is 19.8%, without evidence of a plateau. Patients who developed MDS received significantly fewer numbers of cells reinfused per kilogram at ABMT (P =.0003). Karyotypes were performed on bone marrow samples of 33 patients, and 29 patients had either del(7) or complex abnormalities. The median survival from diagnosis of MDS was 9.4 months. The International Prognostic Scoring System for MDS failed to predict outcome in these patients. Thirteen patients underwent allogeneic BMT as treatment for MDS, and all have died of BMT-related complications (11 patients) or relapse (two patients), with a median survival of only 1.8 months. CONCLUSION: Long-term follow-up demonstrates a high incidence of MDS after ABMT for NHL. The prognosis for these patients is uniformly poor, and novel treatment strategies are needed for this fatal disorder.
PURPOSE: The absolute risk of myelodysplastic syndrome (MDS) after autologous bone marrow transplant (ABMT) for non-Hodgkin's lymphoma (NHL) exceeds 5% in several reported series. We report the outcome of a large cohort of patients who developed MDS after ABMT for NHL. PATIENTS AND METHODS: Between December 1982 and December 1997, 552 patients underwent ABMT for NHL, with a uniform ablative regimen of cyclophosphamide and total body irradiation followed by reinfusion of obtained marrow purged with monoclonal antibodies. MDS was strictly defined, using the French-American-British classification system, as requiring bone marrow dysplasia in at least two cell lines, with associated unexplained persistent cytopenias. RESULTS: Forty-one patients developed MDS at a median of 47 months after ABMT. The incidence of MDS was 7.4%, and actuarial incidence at 10 years is 19.8%, without evidence of a plateau. Patients who developed MDS received significantly fewer numbers of cells reinfused per kilogram at ABMT (P =.0003). Karyotypes were performed on bone marrow samples of 33 patients, and 29 patients had either del(7) or complex abnormalities. The median survival from diagnosis of MDS was 9.4 months. The International Prognostic Scoring System for MDS failed to predict outcome in these patients. Thirteen patients underwent allogeneic BMT as treatment for MDS, and all have died of BMT-related complications (11 patients) or relapse (two patients), with a median survival of only 1.8 months. CONCLUSION: Long-term follow-up demonstrates a high incidence of MDS after ABMT for NHL. The prognosis for these patients is uniformly poor, and novel treatment strategies are needed for this fatal disorder.
Authors: I Vaxman; R Ram; A Gafter-Gvili; L Vidal; M Yeshurun; M Lahav; O Shpilberg Journal: Bone Marrow Transplant Date: 2015-02-09 Impact factor: 5.483
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Authors: Christopher J Gibson; R Coleman Lindsley; Vatche Tchekmedyian; Brenton G Mar; Jiantao Shi; Siddhartha Jaiswal; Alysia Bosworth; Liton Francisco; Jianbo He; Anita Bansal; Elizabeth A Morgan; Ann S Lacasce; Arnold S Freedman; David C Fisher; Eric Jacobsen; Philippe Armand; Edwin P Alyea; John Koreth; Vincent Ho; Robert J Soiffer; Joseph H Antin; Jerome Ritz; Sarah Nikiforow; Stephen J Forman; Franziska Michor; Donna Neuberg; Ravi Bhatia; Smita Bhatia; Benjamin L Ebert Journal: J Clin Oncol Date: 2017-01-09 Impact factor: 44.544
Authors: J Kothari; M Foley; K S Peggs; S Mackenzie; K Thomson; E Morris; K M Ardeshna; A E Virchis; D C Linch; J Lambert Journal: Bone Marrow Transplant Date: 2016-05-23 Impact factor: 5.483
Authors: Mohammad Faizan Zahid; Aric Parnes; Bipin N Savani; Mark R Litzow; Shahrukh K Hashmi Journal: World J Stem Cells Date: 2016-08-26 Impact factor: 5.326
Authors: A Deol; J Abrams; A Masood; Z Al-Kadhimi; M H Abidi; L Ayash; L G Lum; V Ratanatharathorn; J P Uberti Journal: Bone Marrow Transplant Date: 2013-03-11 Impact factor: 5.483