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High incidence of myelodysplasia and secondary leukaemia in the UK Medical Research Council Pilot of autografting in chronic lymphocytic leukaemia
Author(s) -
Milligan Donald W.,
Kochethu Geothy,
Dearden Claire,
Matutes Estella,
MacConkey Christopher,
Catovsky Daniel
Publication year - 2006
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/j.1365-2141.2006.05982.x
Subject(s) - fludarabine , medicine , incidence (geometry) , cyclophosphamide , chronic lymphocytic leukemia , total body irradiation , myelodysplastic syndromes , transplantation , surgery , risk factor , chronic myeloid leukaemia , chemotherapy , oncology , leukemia , bone marrow , physics , optics
Summary We report a high incidence of myelodysplastic syndrome (MDS)/acute myeloid leukaemia (AML) in patients entered into the Medical Research Council Chronic Lymphocytic Leukaemia‐5 trial. Of 115 newly diagnosed patients treated with fludarabine, 65 patients proceeded to autologous transplant. Conditioning was cyclophosphamide and total body irradiation in 49 (75%) patients and chemotherapy in 12 (18%). Ten patients have developed MDS/AML; eight had undergone an autograft. Five‐year actuarial risk of developing MDS/AML postautograft was 12·4% (95% confidence interval, 2·5–24%). No analysed potential risk factor was predictive for MDS/AML development. We hypothesise that potential causative factors are fludarabine, low cell dose and transplant conditioning.