Therapy-related acute myeloid leukemia and myelodysplastic syndrome after hematopoietic cell transplantation for lymphoma

S. Yamasaki; R. Suzuki; K. Hatano; K. Fukushima; H. Iida; S. Morishima; Y. Suehiro; T. Fukuda; N. Uchida; H. Uchiyama; H. Ikeda; A. Yokota; K. Tsukasaki; H. Yamaguchi; J. Kuroda; H. Nakamae; Y. Adachi; K. I. Matsuoka; Y. Nakamura; Y. Atsuta; J. Suzumiya

doi:10.1038/bmt.2017.52

Therapy-related acute myeloid leukemia and myelodysplastic syndrome after hematopoietic cell transplantation for lymphoma

S. Yamasaki, R. Suzuki, K. Hatano, K. Fukushima, H. Iida, S. Morishima, Y. Suehiro, T. Fukuda, N. Uchida, H. Uchiyama, H. Ikeda, A. Yokota, K. Tsukasaki, H. Yamaguchi, J. Kuroda, H. Nakamae, Y. Adachi, K. I. Matsuoka, Y. Nakamura, Y. AtsutaJ. Suzumiya

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Abstract

Therapy-related acute myeloid leukemia and myelodysplastic syndrome (t-AML/MDS) represent severe late effects in patients receiving hematopoietic cell transplantation (HCT) for lymphoma. The choice between high-dose therapy with autologous HCT and allogeneic HCT with reduced-intensity conditioning remains controversial in patients with relapsed lymphoma. We retrospectively analyzed incidence and risk factors for the development of t-AML/MDS in lymphoma patients treated with autologous or allogeneic HCT. A total of 13 810 lymphoma patients who received autologous (n=9963) or allogeneic (n=3847) HCT between 1985 and 2012 were considered. At a median overall survival (OS) of 52 and 46 months in autologous and allogeneic HCT groups, respectively, lymphoma patients receiving autologous HCT (1.38% at 3 years after autologous HCT) had a significant risk for developing t-AML/MDS compared to allogeneic HCT (0.37% at 3 years after allogeneic HCT, P<0.001). Significant risk factors for the development of t-AML/MDS after autologous and allogeneic HCT were high-stage risk at HCT (P=0.04) or secondary malignancies (P<0.001) and receiving cord blood stem cell (P=0.03) or involved field radiotherapy (P=0.002), respectively. Strategies that carefully select lymphoma patients for autologous HCT, by excluding lymphoma patients with high-stage risk at HCT, may allow the identification of individual lymphoma patients at particular high risk for t-AML/MDS.

Original language	English
Pages (from-to)	969-976
Number of pages	8
Journal	Bone Marrow Transplantation
Volume	52
Issue number	7
DOIs	https://doi.org/10.1038/bmt.2017.52
Publication status	Published - Jul 1 2017

ASJC Scopus subject areas

Hematology
Transplantation

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Yamasaki, S., Suzuki, R., Hatano, K., Fukushima, K., Iida, H., Morishima, S., Suehiro, Y., Fukuda, T., Uchida, N., Uchiyama, H., Ikeda, H., Yokota, A., Tsukasaki, K., Yamaguchi, H., Kuroda, J., Nakamae, H., Adachi, Y., Matsuoka, K. I., Nakamura, Y., ... Suzumiya, J. (2017). Therapy-related acute myeloid leukemia and myelodysplastic syndrome after hematopoietic cell transplantation for lymphoma. Bone Marrow Transplantation, 52(7), 969-976. https://doi.org/10.1038/bmt.2017.52

Yamasaki, S, Suzuki, R, Hatano, K, Fukushima, K, Iida, H, Morishima, S, Suehiro, Y, Fukuda, T, Uchida, N, Uchiyama, H, Ikeda, H, Yokota, A, Tsukasaki, K, Yamaguchi, H, Kuroda, J, Nakamae, H, Adachi, Y, Matsuoka, KI, Nakamura, Y, Atsuta, Y & Suzumiya, J 2017, 'Therapy-related acute myeloid leukemia and myelodysplastic syndrome after hematopoietic cell transplantation for lymphoma', Bone Marrow Transplantation, vol. 52, no. 7, pp. 969-976. https://doi.org/10.1038/bmt.2017.52

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abstract = "Therapy-related acute myeloid leukemia and myelodysplastic syndrome (t-AML/MDS) represent severe late effects in patients receiving hematopoietic cell transplantation (HCT) for lymphoma. The choice between high-dose therapy with autologous HCT and allogeneic HCT with reduced-intensity conditioning remains controversial in patients with relapsed lymphoma. We retrospectively analyzed incidence and risk factors for the development of t-AML/MDS in lymphoma patients treated with autologous or allogeneic HCT. A total of 13 810 lymphoma patients who received autologous (n=9963) or allogeneic (n=3847) HCT between 1985 and 2012 were considered. At a median overall survival (OS) of 52 and 46 months in autologous and allogeneic HCT groups, respectively, lymphoma patients receiving autologous HCT (1.38% at 3 years after autologous HCT) had a significant risk for developing t-AML/MDS compared to allogeneic HCT (0.37% at 3 years after allogeneic HCT, P<0.001). Significant risk factors for the development of t-AML/MDS after autologous and allogeneic HCT were high-stage risk at HCT (P=0.04) or secondary malignancies (P<0.001) and receiving cord blood stem cell (P=0.03) or involved field radiotherapy (P=0.002), respectively. Strategies that carefully select lymphoma patients for autologous HCT, by excluding lymphoma patients with high-stage risk at HCT, may allow the identification of individual lymphoma patients at particular high risk for t-AML/MDS.",

author = "S. Yamasaki and R. Suzuki and K. Hatano and K. Fukushima and H. Iida and S. Morishima and Y. Suehiro and T. Fukuda and N. Uchida and H. Uchiyama and H. Ikeda and A. Yokota and K. Tsukasaki and H. Yamaguchi and J. Kuroda and H. Nakamae and Y. Adachi and Matsuoka, {K. I.} and Y. Nakamura and Y. Atsuta and J. Suzumiya",

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AU - Suzuki, R.

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AU - Iida, H.

AU - Morishima, S.

AU - Suehiro, Y.

AU - Fukuda, T.

AU - Uchida, N.

AU - Uchiyama, H.

AU - Ikeda, H.

AU - Yokota, A.

AU - Tsukasaki, K.

AU - Yamaguchi, H.

AU - Kuroda, J.

AU - Nakamae, H.

AU - Adachi, Y.

AU - Matsuoka, K. I.

AU - Nakamura, Y.

AU - Atsuta, Y.

AU - Suzumiya, J.

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N2 - Therapy-related acute myeloid leukemia and myelodysplastic syndrome (t-AML/MDS) represent severe late effects in patients receiving hematopoietic cell transplantation (HCT) for lymphoma. The choice between high-dose therapy with autologous HCT and allogeneic HCT with reduced-intensity conditioning remains controversial in patients with relapsed lymphoma. We retrospectively analyzed incidence and risk factors for the development of t-AML/MDS in lymphoma patients treated with autologous or allogeneic HCT. A total of 13 810 lymphoma patients who received autologous (n=9963) or allogeneic (n=3847) HCT between 1985 and 2012 were considered. At a median overall survival (OS) of 52 and 46 months in autologous and allogeneic HCT groups, respectively, lymphoma patients receiving autologous HCT (1.38% at 3 years after autologous HCT) had a significant risk for developing t-AML/MDS compared to allogeneic HCT (0.37% at 3 years after allogeneic HCT, P<0.001). Significant risk factors for the development of t-AML/MDS after autologous and allogeneic HCT were high-stage risk at HCT (P=0.04) or secondary malignancies (P<0.001) and receiving cord blood stem cell (P=0.03) or involved field radiotherapy (P=0.002), respectively. Strategies that carefully select lymphoma patients for autologous HCT, by excluding lymphoma patients with high-stage risk at HCT, may allow the identification of individual lymphoma patients at particular high risk for t-AML/MDS.

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Therapy-related acute myeloid leukemia and myelodysplastic syndrome after hematopoietic cell transplantation for lymphoma

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