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Impact of primary disease on outcome after allogeneic stem cell transplantation for transformed secondary acute leukaemia
Author(s) -
Kröger Nicolaus,
Eikema DiderikJan,
Köster Linda,
Beelen Dietrich,
de Wreede Liesbeth C.,
Finke Jürgen,
Koenecke Christian,
Niederwieser Dietger,
Bornhäuser Martin,
Schoenland Stefan,
Potter Victoria,
Wolschke Christine,
Maertens Johan,
Theobald Matthias,
Kobbe Guido,
ItäläRemes Maija,
Wulf Gerald,
Kahls Peter,
Forcade Edouard,
Greinix Hildegard,
Masszi Tamás,
YakoubAgha Ibrahim,
Chalandon Yves,
Robin Marie
Publication year - 2019
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 - 10.1111/bjh.15819
Subject(s) - transplantation , cumulative incidence , medicine , hematopoietic stem cell transplantation , myelodysplastic syndromes , oncology , stem cell , immunology , gastroenterology , bone marrow , biology , genetics
Summary Myelodysplastic syndromes ( MDS ), myeloproliferative neoplasms ( MPN ) and chronic myelomonocytic leukaemia ( CMML ) can progress to secondary acute myeloid leukaemia ( sAML ). We compared the outcome of 4214 sAML patients who received allogeneic haematopoietic stem cell transplantation (allo‐ HSCT ) from an unrelated (62%) or human leucocyte antigen ( HLA )‐identical sibling donor (38%) according the underlying disease: MDS ( n = 3541), CMML ( n = 251) or MPN ( n = 422). After a median follow up of 46·5 months, the estimated 3‐year progression‐free ( PFS ) and overall survival ( OS ) for the entire group was 36% (34–37%) and 41% (40–43%), respectively. The cumulative incidence of relapse and non‐relapse mortality ( NRM ) was 37% (35–39%) and 27% (26–29%), respectively. In a multivariable analysis for OS , besides age ( P < 0·001), unrelated donor ( P = 0·011), cytomegalovirus ± constellation ( P = 0·007), Karnofsky index ≤ 80 ( P < 0·001), remission status ( P < 0·001), peripheral blood as stem cell source ( P = 0·009), sAML from MPN ( P = 0·003) remained a significant factor in comparison to sAML from MDS , while worse outcome of sAML from CMML did not reach statistical significance ( P = 0·06). This large registry study demonstrates a major impact of the underlying disease on outcome of sAML after allo‐HSCT.