1.
Primary Cancer Matters in Therapy-related Myeloid Neoplasm Patients Receiving Allogeneic Hematopoietic Cell Transplantation: A Study From the Chronic Malignancies Working Party of the EBMT
Robin, M., de Wreede, L. C., Schroeder, T., Stölzel, F., Kröger, N., Koster, L., Platzbecker, U., Finke, J., Ganser, A., Blaise, D., et al
HemaSphere. 2023;7(4):e851
2.
Impact of primary disease on outcome after allogeneic stem cell transplantation for transformed secondary acute leukaemia
Kroger, N., Eikema, D. J., Koster, L., Beelen, D., de Wreede, L. C., Finke, J., Koenecke, C., Niederwieser, D., Bornhauser, M., Schoenland, S., et al
British journal of haematology. 2019
Abstract
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.
3.
Late treatment-related mortality versus competing causes of death after allogeneic transplantation for myelodysplastic syndromes and secondary acute myeloid leukemia
Schetelig, J., de Wreede, L. C., van Gelder, M., Koster, L., Finke, J., Niederwieser, D., Beelen, D., Mufti, G. J., Platzbecker, U., Ganser, A., et al
Leukemia. 2018
Abstract
The causes and rates of late patient-mortality following alloHCT for myelodysplastic syndromes or secondary acute myeloid leukemia were studied, to assess the contribution of relapse-related, treatment-related, and population factors. Data from EBMT on 6434 adults, who received a first alloHCT from January 2000 to December 2012, were retrospectively studied using combined land-marking, relative-survival methods and multi-state modeling techniques. Median age at alloHCT increased from 49 to 58 years, and the number of patients aged ≥65 years at alloHCT increased from 5 to 17%. Overall survival probability was 53% at 2 years and 35% at 10 years post-alloHCT. Survival probability at 5 years from the 2-year landmark was 88% for patients <45-year old and 63% for patients ≥65-year old at alloHCT. Cumulative incidence of nonrelapse mortality (NRM) for patients <45-year old at transplant was 7% rising to 25% for patients aged ≥65. For older patients, 31% of NRM-deaths could be attributed to population mortality. Favorable post-alloHCT long-term survival was seen; however, excess mortality-risk for all age groups was shown compared to the general population. A substantial part of total NRM for older patients was attributable to population mortality, information which aids the balanced explanation of post-HCT risk and helps improve long-term care.