Allogeneic Transplantation to Treat Therapy-Related Myelodysplastic Syndrome and Acute Myelogenous Leukemia in Adults.

Autor: Metheny L; Seidman Cancer Center, University Hospitals Cleveland Medical Center, Cleveland, Ohio. Electronic address: Leland.metheny@uhhospitals.org., Callander NS; University of Wisconsin Carbone Cancer Center, Madison, Wisconsin., Hall AC; University of Wisconsin Hospital and Clinics, Madison, Wisconsin., Zhang MJ; Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Biostatistics, Institute for Health and Society, Medical College of Wisconsin, Milwaukee, Wisconsin., Bo-Subait K; Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin., Wang HL; Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin., Agrawal V; Division of Blood and Marrow Transplantation, Department of Medicine, Stanford University School of Medicine, Stanford, California., Al-Homsi AS; New York University Langone Health, New York, New York., Assal A; Columbia University Irving Medical Center, Department of Medicine, Bone Marrow Transplant and Cell Therapy Program, New York, New York., Bacher U; Department of Hematology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland., Beitinjaneh A; Division of Transplantation and Cellular Therapy, University of Miami, Miami, Florida., Bejanyan N; Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, Minneapolis, Minnesota., Bhatt VR; The Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, Nebraska., Bredeson C; The Ottawa Hospital Blood and Marrow Transplant Program and the Ottawa Hospital Research Institute, Ottawa, Ontario, Canada., Byrne M; Vanderbilt University Medical Center, Nashville, Tennessee., Cairo M; Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Department of Pediatrics, New York Medical College, Valhalla, New York., Cerny J; Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, Massachusetts., DeFilipp Z; Hematopoietic Cell Transplant and Cellular Therapy Program, Massachusetts General Hospital, Boston, Massachusetts., Perez MAD; Department of Hematology/Oncology, Hospital Infantil Universitario Niño Jesus, Madrid, Spain., Freytes CO; University of Texas Health Science Center at San Antonio, San Antonio, Texas., Ganguly S; Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, Kansas., Grunwald MR; Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute, Atrium Health, Charlotte, North Carolina., Hashmi S; Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota; Department of Medicine, Sheikh Shakhbout Medical City, Abu Dhavi, United Arab Emirates., Hildebrandt GC; Markey Cancer Center, University of Kentucky, Lexington, Kentucky., Inamoto Y; Division of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan., Kanakry CG; Experimental Transplantation and Immunotherapy Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland., Kharfan-Dabaja MA; Division of Hematology-Oncology, Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, Florida., Lazarus HM; University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio., Lee JW; Division of Hematology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea., Nathan S; Section of Bone Marrow Transplant and Cell Therapy, Rush University Medical Center, Chicago, Illinois., Nishihori T; Department of Blood & Marrow Transplant and Cellular Immunotherapy (BMT CI), Moffitt Cancer Center, Tampa, Florida., Olsson RF; Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Clinical Research Sormland, Uppsala University, Uppsala, Sweden., Ringdén O; Translational Cell Therapy Group, CLINTEC (Clinical Science, Intervention, and Technology) Karolinska Institutet, Stockholm Sweden., Rizzieri D; Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, North Carolina., Savani BN; Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee., Savoie ML; University of Calgary, Calgary, Alberta, Canada., Seo S; Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan., van der Poel M; Maastricht University Medical Center, Maastricht, The Netherlands., Verdonck LF; Department of Hematology/Oncology, Isala Clinic, Zwolle, The Netherlands., Wagner JL; Department of Medical Oncology, Thomas Jefferson University, Philadelphia, Pennsylvania., Yared JA; Blood & Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, Maryland., Hourigan CS; National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland., Kebriaei P; Department of Stem Cell Transplantation, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas., Litzow M; Division of Hematology and Transplant Center, Mayo Clinic Rochester, Rochester, Minnesota., Sandmaier BM; Division of Medical Oncology, University of Washington and Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington., Saber W; Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin., Weisdorf D; Division of Hematology, Oncology and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, Minnesota., de Lima M; Department of Medicine, Seidman Cancer Center, University Hospitals Case Medical Center, Cleveland, Ohio.
Jazyk: angličtina
Zdroj: Transplantation and cellular therapy [Transplant Cell Ther] 2021 Nov; Vol. 27 (11), pp. 923.e1-923.e12. Date of Electronic Publication: 2021 Aug 21.
DOI: 10.1016/j.jtct.2021.08.010
Abstrakt: Patients who develop therapy-related myeloid neoplasm, either myelodysplastic syndrome (t-MDS) or acute myelogenous leukemia (t-AML), have a poor prognosis. An earlier Center for International Blood and Marrow Transplant Research (CIBMTR) analysis of 868 allogeneic hematopoietic cell transplantations (allo-HCTs) performed between 1990 and 2004 showed a 5-year overall survival (OS) and disease-free survival (DFS) of 22% and 21%, respectively. Modern supportive care, graft-versus-host disease prophylaxis, and reduced-intensity conditioning (RIC) regimens have led to improved outcomes. Therefore, the CIBMTR analyzed 1531 allo-HCTs performed in adults with t-MDS (n = 759) or t-AML (n = 772) between and 2000 and 2014. The median age was 59 years (range, 18 to 74 years) for the patients with t-MDS and 52 years (range, 18 to 77 years) for those with t-AML. Twenty-four percent of patients with t-MDS and 11% of those with t-AML had undergone a previous autologous (auto-) HCT. A myeloablative conditioning (MAC) regimen was used in 49% of patients with t-MDS and 61% of patients with t-AML. Nonrelapse mortality at 5 years was 34% (95% confidence interval [CI], 30% to 37%) for patients with t-MDS and 34% (95% CI, 30% to 37%) for those with t-AML. Relapse rates at 5 years in the 2 groups were 46% (95% CI, 43% to 50%) and 43% (95% CI, 40% to 47%). Five-year OS and DFS were 27% (95% CI, 23% to 31%) and 19% (95% CI, 16% to 23%), respectively, for patients with t-MDS and 25% (95% CI, 22% to 28%) and 23% (95% CI, 20% to 26%), respectively, for those with t-AML. In multivariate analysis, OS and DFS were significantly better in young patients with low-risk t-MDS and those with t-AML undergoing HCT with MAC while in first complete remission, but worse for those with previous auto-HCT, higher-risk cytogenetics or Revised International Prognostic Scoring System score, and a partially matched unrelated donor. Relapse remains the major cause of treatment failure, with little improvement seen over the past 2 decades. These data mandate caution when recommending allo-HCT in these conditions and indicate the need for more effective antineoplastic approaches before and after allo-HCT.
(Copyright © 2021. Published by Elsevier Inc.)
Databáze: MEDLINE
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