Allogeneic transplantation for therapy-related myelodysplastic syndrome and acute myeloid leukemia

被引：167

作者：

Litzow, Mark R. ^{[2
]}

Tarima, Sergey

Perez, Waleska S. ^{[3
]}

Bolwell, Brian J. ^{[4
]}

Cairo, Mitchell S. ^{[5
]}

Camitta, Bruce M. ^{[6
]}

Cutler, Corey S. ^{[7
]}

de Lima, Marcos ^{[8
]}

DiPersio, John F. ^{[9
]}

Gale, Robert Peter ^{[10
]}

Keating, Armand ^{[11
]}

Lazarus, Hillard M. ^{[12
]}

Luger, Selina ^{[13
]}

Marks, David I. ^{[14
]}

Maziarz, Richard T. ^{[15
]}

McCarthy, Philip L. ^{[16
]}

Pasquini, Marcelo C. ^{[3
]}

Phillips, Gordon L. ^{[17
]}

Rizzo, J. Douglas ^{[3
]}

Sierra, Jorge ^{[18
]}

Tallman, Martin S. ^{[19
]}

Weisdorf, Daniel J. ^{[1
]}

机构：

[1] Univ Minnesota, Med Ctr, Adult Blood & Marrow Transplant Program, Minneapolis, MN 55455 USA

[2] Mayo Clin, Rochester, MN USA

[3] Med Coll Wisconsin, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA

[4] Cleveland Clin Fdn, Cleveland, OH USA

[5] Morgan Stanley Childrens Hosp NY Presbyterian, New York, NY USA

[6] Childrens Hosp Wisconsin, Milwaukee, WI 53201 USA

[7] Dana Farber Canc Inst, Boston, MA 02115 USA

[8] Univ Texas MD Anderson Canc Ctr, Houston, TX 77030 USA

[9] St Louis Childrens Hosp, St Louis, MO USA

[10] Celgene Corp, Summit, NJ USA

[11] Princess Margaret Hosp, Toronto, ON M4X 1K9, Canada

[12] Univ Hosp Cleveland, Case Med Ctr, Cleveland, OH 44106 USA

[13] Hosp Univ Penn, Philadelphia, PA 19104 USA

[14] United Bristol Healthcare, Bristol, Avon, England

[15] Oregon Hlth & Sci Univ, Portland, OR 97201 USA

[16] Roswell Pk Canc Inst, Buffalo, NY 14263 USA

[17] Univ Rochester, Med Ctr, Rochester, NY 14627 USA

[18] Hosp Santa Cruz & Sant Pau, Barcelona, Spain

[19] NW Mem Hosp, Chicago, IL 60611 USA

来源：

BLOOD | 2010年 / 115卷 / 09期

关键词：

BONE-MARROW-TRANSPLANTATION; STEM-CELL TRANSPLANTATION; ACUTE NONLYMPHOCYTIC LEUKEMIA; DOSE CYTOSINE-ARABINOSIDE; LATE COMPLICATION; HOST DISEASE; RISK-FACTORS; LYMPHOMA; CHEMOTHERAPY; CYTOGENETICS;

D O I：

10.1182/blood-2009-10-249128

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Therapy-related myelodysplastic syndromes (t-MDSs) and acute myeloid leukemia (t-AML) have a poor prognosis with conventional therapy. Encouraging results are reported after allogeneic transplantation. We analyzed outcomes in 868 persons with t-AML (n = 545) or t-MDS (n = 323) receiving allogeneic transplants from 1990 to 2004. A myeloablative regimen was used for conditioning in 77%. Treatment-related mortality (TRM) and relapse were 41% (95% confidence interval [CI], 38-44) and 27% (24-30) at 1 year and 48% (44-51) and 31% (28-34) at 5 years, respectively. Disease-free (DFS) and overall survival (OS) were 32% (95% CI, 29-36) and 37% (34-41) at 1 year and 21% (18-24) and 22% (19-26) at 5 years, respectively. In multivariate analysis, 4 risk factors had adverse impacts on DFS and OS: (1) age older than 35 years; (2) poor-risk cytogenetics; (3) t-AML not in remission or advanced t-MDS; and (4) donor other than an HLA-identical sibling or a partially or well-matched unrelated donor. Five-year survival for subjects with none, 1, 2, 3, or 4 of these risk factors was 50% (95% CI, 38-61), 26% (20-31), 21% (16-26), 10% (5-15), and 4% (0-16), respectively (P < .001). These data permit a more precise prediction of outcome and identify subjects most likely to benefit from allogeneic transplantation. (Blood. 2010; 115: 1850-1857)

引用

页码：1850 / 1857

页数：8

共 30 条

[1] Stem cell transplantation for secondary acute myeloid leukemia: Evaluation of transplantation as initial therapy or following induction chemotherapy [J].

Anderson, JE ;

Gooley, TA ;

Schoch, G ;

Anasetti, C ;

Bensinger, WI ;

Clift, RA ;

Hansen, JA ;

Sanders, JE ;

Storb, R ;

Appelbaum, FR .

BLOOD, 1997, 89 (07) :2578-2585

[2] Impact of cytogenetics on outcome of de novo and therapy-related AML and MDS after allogeneic transplantation [J].

Armand, Philippe ;

Kim, Haesook T. ;

DeAngelo, Daniel J. ;

Ho, Vincent T. ;

Cutler, Corey S. ;

Stone, Richard M. ;

Ritz, Jerome ;

Alyea, Edwin P. ;

Antin, Joseph H. ;

Soiffer, Robert J. .

BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION, 2007, 13 (06) :655-664

[3]

ATKINSON K, 1990, BLOOD, V75, P2459

[4] Bone marrow transplantation for therapy-related myelodysplasia: comparison with primary myelodysplasia [J].

Ballen, KK ;

Gilliland, DG ;

Guinan, EC ;

Hsieh, CC ;

Parsons, SK ;

Rimm, IJ ;

Ferrara, JLM ;

Bierer, BE ;

Weinstein, HJ ;

Antin, JH .

BONE MARROW TRANSPLANTATION, 1997, 20 (09) :737-743

[5] Therapy-related acute myelogenous leukemia and myelodysplastic syndrome [J].

Borthakur G. ;

Estey E.E. .

Current Oncology Reports, 2007, 9 (5) :373-377

[6] A CRITICAL-APPRAISAL OF LOW-DOSE CYTOSINE-ARABINOSIDE IN PATIENTS WITH ACUTE NONLYMPHOCYTIC LEUKEMIA AND MYELODYSPLASTIC SYNDROMES [J].

CHESON, BD ;

JASPERSE, DM ;

SIMON, R ;

FRIEDMAN, MA .

JOURNAL OF CLINICAL ONCOLOGY, 1986, 4 (12) :1857-1864

[7] EVALUATION OF CONTINUOUS INFUSION LOW-DOSE 5-AZACYTIDINE IN THE TREATMENT OF MYELODYSPLASTIC SYNDROMES [J].

CHITAMBAR, CR ;

LIBNOCH, JA ;

MATTHAEUS, WG ;

ASH, RC ;

RITCH, PS ;

ANDERSON, T .

AMERICAN JOURNAL OF HEMATOLOGY, 1991, 37 (02) :100-104

[8] A RANDOMIZED TRIAL OF 13-CIS RETINOIC ACID WITH OR WITHOUT CYTOSINE-ARABINOSIDE IN PATIENTS WITH THE MYELODYSPLASTIC SYNDROME [J].

CLARK, RE ;

ISMAIL, SAD ;

JACOBS, A ;

PAYNE, H ;

SMITH, SA .

BRITISH JOURNAL OF HAEMATOLOGY, 1987, 66 (01) :77-83

[9]

de Witte T, 1991, Bone Marrow Transplant, V7 Suppl 2, P40

[10] Efficacy of azacitidine compared with that of conventional care regimens in the treatment of higher-risk myelodysplastic syndromes: a randomised, open-label, phase III study [J].

Fenaux, Pierre ;

Mufti, Ghulam J. ;

Hellstrom-Lindberg, Eva ;

Santini, Valeria ;

Finelli, Carlo ;

Giagounidis, Aristoteles ;

Schoch, Robert ;

Gattermann, Norbert ;

Sanz, Guillermo ;

List, Alan ;

Gore, Steven D. ;

Seymour, John F. ;

Bennett, John M. ;

Byrd, John ;

Backstrom, Jay ;

Zimmerman, Linda ;

McKenzie, David ;

Beach, C. L. ;

Silverman, Lewis R. .

LANCET ONCOLOGY, 2009, 10 (03) :223-232

← 1 2 3 →