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Secondary leukaemia and myelodysplasia after autografting for lymphoma: results from the EBMT
Author(s) -
Milligan Donald W.,
Ruiz de Elvira M. Carmen,
Kolb HansJochem,
Goldstone Anthony H.,
Meloni Giovanna,
Rohatiner Ama Z.,
Colombat Phillip,
Schmitz Norbert
Publication year - 1999
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1046/j.1365-2141.1999.01627.x
Subject(s) - medicine , lymphoma , incidence (geometry) , myelodysplastic syndromes , radiation therapy , transplantation , risk factor , chemotherapy , oncology , disease , hodgkin lymphoma , surgery , bone marrow , physics , optics
Between 1978 and 1996 more than 7500 lymphoma transplants have been reported to the European Bone Marrow Transplantation (EBMT) Lymphoma Registry. This has been examined to establish the incidence of secondary leukaemia and myelodysplasia and to relate this to possible prognostic factors. 131 centres representing 4998 patients responded to a questionnaire. This identified 66 patients with post transplant myelodysplastic syndrome (MDS)/acute myeloid leukaemia (AML). The actuarial risk for MDS/AML at 5 years post‐transplant (±95% CI) was 4.6% (3.1–6.8) for Hodgkin's disease and 3.0% (2.0–4.3) for non‐Hodgkin's lymphoma. Multivariate analysis for all patients demonstrated an effect of age at transplant, radiotherapy at conditioning, number of transplants and interval between diagnosis and transplant as risk factors. For patients with NHL, grade of histology was important (low grade > intermediate or high‐grade); for Hodgkin's disease, female sex was identified as a risk factor. These findings suggest that the incidence of MDS/AML may not be greater following an autograft than after conventional chemotherapy.