Title :

Outcomes of CMML patients undergoing allo-HCT are significantly worse compared to MDS-a study of the CMWP of the EBMT.

Author(s) :

Rovó, Alicia [Auteur]
Bern University Hospital [Berne] [Inselspital]
Gras, Luuk [Auteur]
Universiteit Leiden = Leiden University
Piepenbroek, Brian [Auteur]
Universiteit Leiden = Leiden University
Kröger, Nicolaus [Auteur]
University Hospital Hamburg-Eppendorf
Reinhardt, H. Christian [Auteur]
University Hospital Essen [AöR]
Radujkovic, Aleksandar [Auteur]
University of Heidelberg, Medical Faculty
Blaise, Didier [Auteur]
Centre de Recherche en Cancérologie de Marseille [CRCM]
Kobbe, Guido [Auteur]
University Hospital Düsseldorf
Niityvuopio, Riitta [Auteur]
HUS Medical Imaging Center [Helsinki] [HUS-MIC]
Platzbecker, Uwe [Auteur]
University Hospital Leipzig = Universitätsklinikum Leipzig
Sockel, Katja [Auteur]
University Hospital Carl Gustav Carus [Dresden, Germany]
Hunault-Berger, Mathilde [Auteur]
Centre Hospitalier Universitaire d'Angers [CHU Angers]
Cornelissen, J. J. [Auteur]
Erasmus University Medical Center [Rotterdam] [Erasmus MC]
Forcade, Edouard [Auteur]
CHU Bordeaux
Bourhis, Jean Henri [Auteur]
Institut Gustave Roussy [IGR]
Chalandon, Yves [Auteur]
Hôpitaux Universitaires de Genève [HUG]
Kinsella, Francesca [Auteur]
Birmingham Women's and Children's NHS Foundation Trust
Nguyen-Quoc, Stéphanie [Auteur]
CHU Pitié-Salpêtrière [AP-HP]
Maertens, Johan [Auteur]
University Hospital Gasthuisberg [Leuven]
Elmaagacli, Ahmet [Auteur]
Asklepios Klinikum Harburg [Hamburg, Germany] [AKH]
Mordini, Nicola [Auteur]
Hayden, Patrick [Auteur]
Trinity College Dublin
Raj, Kavita [Auteur]
University College London Hospitals NHS Foundation Trust [London, UK] [UCLH]
Drozd-Sokolowska, Joanna [Auteur]
Medical University of Warsaw - Poland
De Wreede, Liesbeth C. [Auteur]
Leiden University Medical Center [LUMC]
Mclornan, Donal P. [Auteur]
University College London Hospitals NHS Foundation Trust [London, UK] [UCLH]
Robin, Marie [Auteur]
Hopital Saint-Louis [AP-HP] [AP-HP]
Yakoub-Agha, Ibrahim [Auteur]
Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286
Onida, Francesco [Auteur]
Università degli Studi di Milano = University of Milan [UNIMI]

Journal title :

American Journal of Hematology

Abbreviated title :

Am J Hematol

Publication date :

2023-11-28

ISSN :

1096-8652

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Although CMML since long has been separated from MDS, many studies continue to evaluate the outcomes of both diseases after hematopoietic cell transplantation (allo-HCT) together. Data evaluating outcomes of a large CMML ...
Show more >Although CMML since long has been separated from MDS, many studies continue to evaluate the outcomes of both diseases after hematopoietic cell transplantation (allo-HCT) together. Data evaluating outcomes of a large CMML cohort after allo-HCT compared to MDS are limited. We aim to compare outcomes of CMML to MDS patients who underwent allo-HCT between 2010 and 2018. Patients ≥18 years with CMML and MDS undergoing allo-HCT reported to the EBMT registry were analyzed. Progression to AML before allo-HCT was an exclusion criterion. Overall survival (OS), progression/relapse-free survival (PFS), relapse incidence (including progression) (REL), and non-relapse mortality (NRM) were evaluated in univariable and multivariable (MVA) Cox proportional hazard models including interaction terms between disease and confounders. In total, 10832 patients who underwent allo-HCT were included in the study, there were a total of 1466 CMML, and 9366 MDS. The median age at time of allo-HCT in CMML (median 60.5, IQR 54.3–65.2 years) was significantly higher than in the MDS cohort (median 58.8, IQR 50.2–64.5 years; p < .001). A significantly higher percentage of CMML patients were male (69.4%) compared to MDS (61.2%; p < .001). There were no clinically meaningful differences in the distribution of Karnofsky score, Sorror HCT-CI score at allo-HCT, and donor type, between the CMML and MDS patients. RIC platforms were utilized in 63.9% of CMML allo-HCT, and in 61.4% of MDS patients (p = .08). In univariable analyses, we found that OS, PFS, and REL were significantly worse in CMML when compared with MDS (all p < .0001), whereas no significant difference was observed in NRM (p = .77). In multivariable analyses, the HR comparing MDS versus CMML for OS was 0.81 (95% CI, 0.74–0.88, p < .001), PFS 0.76 (95% CI 0.70–0.82, p < .001), relapse 0.66 (95% CI 0.59–0.74, p < .001), and NRM 0.87 (95% CI 0.78–0.98, p = .02), respectively. The association between baseline variables and outcome was found to be similar in MDS and CMML (all interaction p > .05) except for a decreasing trend over time of the risk of relapse in CMML (HR allo-HCT per year later 0.94, 95% CI 0.90–0.98), whereas no such trend was observed in MDS (HR 1.00, 95% CI 0.98–1.02). The poor outcome observed for CMML could be related to variables not measured in this study or to factors inherent to the disease itself. This study demonstrates that outcomes of CMML patients after allo-HCT are significantly worse compared to MDS. The results of this study may contribute to future recommendations for allo-HCT in CMML patients.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Université de Lille
Inserm
CHU Lille

Collections :

• Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286

Submission date :

2024-02-06T22:18:47Z
2024-03-19T10:40:19Z