Allogeneic haematopoietic cell transplantation for therapy-related myeloid neoplasms arising following treatment for lymphoma: a retrospective study on behalf of the Chronic Malignancies Working Party of the EBMT.

Abstract

Therapy-related myeloid neoplasms (t-MN), either myelodysplastic neoplasms (t-MDS) or acute myeloid leukemias (t-AML), have a poor prognosis and allogeneic haematopoietic cell transplantation (allo-HCT) represents the only curative option. In this multicenter, registry-based study, we analyzed outcomes of 378 patients undergoing first allo-HCT between 2006-2017 for t-MN arising secondary to lymphoma treatment. Median age was 58 years at allo-HCT; 222 (59%) had a diagnosis of t-MDS and 156 (41%) of t-AML, respectively. At the time of allo-HCT, 46% of t-MN cases were reported as in complete remission (CR) and 15% of lymphomas were recorded as not in remission. A reduced intensity conditioning regimen was used in 70% of cases. For the entire cohort, 5-year OS, and t-MN PFS, relapse incidence and NRM were 32%, 28%, 35% and 37%, respectively. In multivariable analysis, undergoing allo-HCT with t-MN not in CR and older age were associated with significantly worse OS, PFS and NRM. At 5 years post allo-HCT, the relapse incidence of lymphoma was low at 3%, while the rate of secondary malignancies was 8%. This analysis shows the curative potential of allo-HCT for patients with t-MN arising secondary to lymphoma treatment in approximately a third of patients.

• Authors: Mitja Nabergoj, Diderik-Jan Eikema, Linda Koster, Uwe Platzbecker, Katja Sockel, Jürgen Finke, Nicolaus Kröger, Edouard Forcade, Arnon Nagler, Matthias Eder, Johanna Tischer, Annoek E C Broers, Jürgen Kuball, Keith M O Wilson, Mathilde Hunault-Berger, Matthew Collin, Domenico Russo, Lucía López Corral, Grzegorz Helbig, Alberto Mussetti, Christof Scheid, Carmelo Gurnari, Kavita Raj, Joanna Drozd-Sokolowska, Ibrahim Yakoub-Agha, Marie Robin, Donal P McLornan
• Journal: Bone marrow transplantation (Bone Marrow Transplant) Vol. 59 Issue 3 Pg. 395-402 (Mar 2024) ISSN: 1476-5365 [Electronic] England
• PMID: 38195984 (Publication Type: Multicenter Study, Journal Article)
• Copyright: © 2024. The Author(s), under exclusive licence to Springer Nature Limited.

Topics

• Humans
• Middle Aged
• Retrospective Studies
• Leukemia, Myeloid, Acute (therapy)
• Lymphoma (etiology, therapy)
• Recurrence
• Transplantation Conditioning
• Neoplasms, Second Primary (etiology)
• Hematopoietic Stem Cell Transplantation (adverse effects)
• Graft vs Host Disease (etiology)