Skip to Main content Skip to Navigation
Journal articles

Risk factors for therapy-related myelodysplastic syndrome and acute myeloid leukemia treated with allogeneic stem cell transplantation.

Abstract : 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.
Document type :
Journal articles
Complete list of metadatas

Cited literature [25 references]  Display  Hide  Download

https://www.hal.inserm.fr/inserm-00484554
Contributor : Philippe Saas <>
Submitted on : Tuesday, December 28, 2010 - 12:30:13 PM
Last modification on : Wednesday, August 19, 2020 - 11:17:02 AM
Long-term archiving on: : Tuesday, March 29, 2011 - 2:33:19 AM

File

542.pdf
Publisher files allowed on an open archive

Identifiers

Collections

Citation

Nicolaus Kröger, Ronald Brand, Anja van Biezen, Axel Zander, Judith Dierlamm, et al.. Risk factors for therapy-related myelodysplastic syndrome and acute myeloid leukemia treated with allogeneic stem cell transplantation.. Haematologica, Ferrata Storti Foundation, 2009, 94 (4), pp.542-9. ⟨10.3324/haematol.2008.000927⟩. ⟨inserm-00484554⟩

Share

Metrics

Record views

429

Files downloads

1058