TY - JOUR
T1 - Impact of primary disease on outcome after allogeneic stem cell transplantation for transformed secondary acute leukaemia
AU - on behalf of the Chronic Malignancies Working Party of the European Society for Blood Marrow Transplantation
AU - Kröger, Nicolaus
AU - Eikema, Diderik Jan
AU - Köster, Linda
AU - Beelen, Dietrich
AU - de Wreede, Liesbeth C.
AU - Finke, Jürgen
AU - Koenecke, Christian
AU - Niederwieser, Dietger
AU - Bornhäuser, Martin
AU - Schoenland, Stefan
AU - Potter, Victoria
AU - Wolschke, Christine
AU - Maertens, Johan
AU - Theobald, Matthias
AU - Kobbe, Guido
AU - Itälä-Remes, Maija
AU - Wulf, Gerald
AU - Kahls, Peter
AU - Forcade, Edouard
AU - Greinix, Hildegard
AU - Masszi, Tamás
AU - Yakoub-Agha, Ibrahim
AU - Chalandon, Yves
AU - Robin, Marie
PY - 2019/5/1
Y1 - 2019/5/1
N2 - Myelodysplastic syndromes (MDS), myeloproliferative neoplasms (MPN) and chronic myelomonocytic leukaemia (CMML) can progress to secondary acute myeloid leukaemia (sAML). We compared the outcome of 4214 sAML patients who received allogeneic haematopoietic stem cell transplantation (allo-HSCT) from an unrelated (62%) or human leucocyte antigen (HLA)-identical sibling donor (38%) according the underlying disease: MDS (n = 3541), CMML (n = 251) or MPN (n = 422). After a median follow up of 46·5 months, the estimated 3-year progression-free (PFS) and overall survival (OS) for the entire group was 36% (34–37%) and 41% (40–43%), respectively. The cumulative incidence of relapse and non-relapse mortality (NRM) was 37% (35–39%) and 27% (26–29%), respectively. In a multivariable analysis for OS, besides age (P < 0·001), unrelated donor (P = 0·011), cytomegalovirus ± constellation (P = 0·007), Karnofsky index ≤ 80 (P < 0·001), remission status (P < 0·001), peripheral blood as stem cell source (P = 0·009), sAML from MPN (P = 0·003) remained a significant factor in comparison to sAML from MDS, while worse outcome of sAML from CMML did not reach statistical significance (P = 0·06). This large registry study demonstrates a major impact of the underlying disease on outcome of sAML after allo-HSCT.
AB - Myelodysplastic syndromes (MDS), myeloproliferative neoplasms (MPN) and chronic myelomonocytic leukaemia (CMML) can progress to secondary acute myeloid leukaemia (sAML). We compared the outcome of 4214 sAML patients who received allogeneic haematopoietic stem cell transplantation (allo-HSCT) from an unrelated (62%) or human leucocyte antigen (HLA)-identical sibling donor (38%) according the underlying disease: MDS (n = 3541), CMML (n = 251) or MPN (n = 422). After a median follow up of 46·5 months, the estimated 3-year progression-free (PFS) and overall survival (OS) for the entire group was 36% (34–37%) and 41% (40–43%), respectively. The cumulative incidence of relapse and non-relapse mortality (NRM) was 37% (35–39%) and 27% (26–29%), respectively. In a multivariable analysis for OS, besides age (P < 0·001), unrelated donor (P = 0·011), cytomegalovirus ± constellation (P = 0·007), Karnofsky index ≤ 80 (P < 0·001), remission status (P < 0·001), peripheral blood as stem cell source (P = 0·009), sAML from MPN (P = 0·003) remained a significant factor in comparison to sAML from MDS, while worse outcome of sAML from CMML did not reach statistical significance (P = 0·06). This large registry study demonstrates a major impact of the underlying disease on outcome of sAML after allo-HSCT.
KW - allogeneic stem cell transplantation
KW - chronic myelomonocytic leukaemia
KW - MDS
KW - myeloproliferative neoplasm
KW - secondary acute myeloid leukaemia
UR - http://www.scopus.com/inward/record.url?scp=85062335382&partnerID=8YFLogxK
U2 - 10.1111/bjh.15819
DO - 10.1111/bjh.15819
M3 - Article
AN - SCOPUS:85062335382
SN - 0007-1048
VL - 185
SP - 725
EP - 732
JO - British Journal of Haematology
JF - British Journal of Haematology
IS - 4
ER -
