BACKGROUND: After successful treatment of malignant diseases, therapy-related myelodysplastic syndrome and acute myeloid leukemia have emerged as significant problems. DESIGN AND METHODS: The aim of this study was to investigate outcome and risk factors in patients with therapy-related myelodysplastic syndrome or acute myeloid leukemia who underwent allogeneic stem cell transplantation. Between 1981 and 2006, 461 patients with therapy-related myelodysplastic syndrome or acute myeloid, a median age of 40 years and a history of solid tumor (n=163), malignant lymphoma (n=133), or other hematologic diseases (n=57) underwent stem cell transplantation and their data were reported to the European Group for Blood and Marrow Transplantation. RESULTS: The cumulative incidence of non-relapse mortality and relapse at 3 years was 37% and 31%, respectively. In a multivariate analysis significant factors for relapse were not being in complete remission at the time of transplantation (p=0.002), abnormal cytogenetics (p=0.005), higher patients' age (p=0.03) and therapy-related myelodysplastic syndrome (p=0.04), while higher non-relapse mortality was influenced by higher patients' age. Furthermore, there was a marked reduction in non-relapse mortality per calendar year during the study period (p<0.001). The 3-year relapse-free and overall survival rates were 33% and 35%, respectively. In a multivariate analysis significant higher overall survival rates were seen per calendar year (p<0.001), for younger age (<40 years) and normal cytogenetics (p=0.05). Using age (<40 years), abnormal cytogenetics and not being in complete remission at the time of transplantation as risk factors, three different risk groups with overall survival rates of 62%, 33% and 24% could be easily distinguished. CONCLUSIONS: Allogeneic stem cell transplantation can cure patients with therapy-related myelodysplastic syndrome and acute myeloid leukemia and has markedly improved over time. Non-complete remission, abnormal cytogenetics and higher patients' age are the most significant factors predicting survival.
BACKGROUND: After successful treatment of malignant diseases, therapy-related myelodysplastic syndrome and acute myeloid leukemia have emerged as significant problems. DESIGN AND METHODS: The aim of this study was to investigate outcome and risk factors in patients with therapy-related myelodysplastic syndrome or acute myeloid leukemia who underwent allogeneic stem cell transplantation. Between 1981 and 2006, 461 patients with therapy-related myelodysplastic syndrome or acute myeloid, a median age of 40 years and a history of solid tumor (n=163), malignant lymphoma (n=133), or other hematologic diseases (n=57) underwent stem cell transplantation and their data were reported to the European Group for Blood and Marrow Transplantation. RESULTS: The cumulative incidence of non-relapse mortality and relapse at 3 years was 37% and 31%, respectively. In a multivariate analysis significant factors for relapse were not being in complete remission at the time of transplantation (p=0.002), abnormal cytogenetics (p=0.005), higher patients' age (p=0.03) and therapy-related myelodysplastic syndrome (p=0.04), while higher non-relapse mortality was influenced by higher patients' age. Furthermore, there was a marked reduction in non-relapse mortality per calendar year during the study period (p<0.001). The 3-year relapse-free and overall survival rates were 33% and 35%, respectively. In a multivariate analysis significant higher overall survival rates were seen per calendar year (p<0.001), for younger age (<40 years) and normal cytogenetics (p=0.05). Using age (<40 years), abnormal cytogenetics and not being in complete remission at the time of transplantation as risk factors, three different risk groups with overall survival rates of 62%, 33% and 24% could be easily distinguished. CONCLUSIONS: Allogeneic stem cell transplantation can cure patients with therapy-related myelodysplastic syndrome and acute myeloid leukemia and has markedly improved over time. Non-complete remission, abnormal cytogenetics and higher patients' age are the most significant factors predicting survival.
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Authors: Philippe Armand; Haesook T Kim; Daniel J DeAngelo; Vincent T Ho; Corey S Cutler; Richard M Stone; Jerome Ritz; Edwin P Alyea; Joseph H Antin; Robert J Soiffer Journal: Biol Blood Marrow Transplant Date: 2007-03-21 Impact factor: 5.742
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Authors: Z Gul; E Van Meter; M Abidi; I Ditah; M Abdul-Hussein; A Deol; L Ayash; L G Lum; E K Waller; V Ratanatharathorn; J Uberti; Z Al-Kadhimi Journal: Bone Marrow Transplant Date: 2015-01-19 Impact factor: 5.483
Authors: Nirali N Shah; Ulrike Bacher; Terry Fry; Katherine R Calvo; Maryalice Stetler-Stevenson; Diane C Arthur; Roger Kurlander; Kristin Baird; Barbara Wise; Sergio Giralt; Michael Bishop; Nancy M Hardy; Alan S Wayne Journal: Am J Hematol Date: 2012-04-04 Impact factor: 10.047
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: Theo de Witte; David Bowen; Marie Robin; Luca Malcovati; Dietger Niederwieser; Ibrahim Yakoub-Agha; Ghulam J Mufti; Pierre Fenaux; Guillermo Sanz; Rodrigo Martino; Emilio Paolo Alessandrino; Francesco Onida; Argiris Symeonidis; Jakob Passweg; Guido Kobbe; Arnold Ganser; Uwe Platzbecker; Jürgen Finke; Michel van Gelder; Arjan A van de Loosdrecht; Per Ljungman; Reinhard Stauder; Liisa Volin; H Joachim Deeg; Corey Cutler; Wael Saber; Richard Champlin; Sergio Giralt; Claudio Anasetti; Nicolaus Kröger Journal: Blood Date: 2017-01-17 Impact factor: 22.113