Title :

Outcome after relapse of myelodysplastic syndrome and secondary acute myeloid leukemia following allogeneic stem cell transplantation: a retrospective registry analysis on 698 patients by the Chronic Malignancies Working Party of the European Society of Blood and Marrow Transplantation

Author(s) :

Schmid, Christoph [Auteur]
De Wreede Liesbeth, C [Auteur]
Van Biezen, Anja [Auteur]
Finke, Jurgen [Auteur]
Ehninger, Gerhard [Auteur]
Ganser, Arnold [Auteur]
Volin, Liisa [Auteur]
Niederwieser, Dietger [Auteur]
Beelen, Dietrich [Auteur]
Alessandrino Emilio, Paolo [Auteur]
Kanz, Lothar [Auteur]
Schleuning, Michael [Auteur]
Passweg, Jakob [Auteur]
Veelken, Hendrik [Auteur]
Maertens, Johan [Auteur]
Cornelissen Jan, J [Auteur]
Blaise, Didier [Auteur]
Centre de Recherche en Cancérologie de Marseille [CRCM]
Gramatzki, Martin [Auteur]
Milpied, Noel [Auteur]
Yakoub-Agha, Ibrahim [Auteur]
Lille Inflammation Research International Center - U 995 [LIRIC]
Mufti, Ghulam [Auteur]
Rovira, Montserrat [Auteur]
Arnold, Renate [Auteur]
De Witte, Theo [Auteur]
Robin, Marie [Auteur]
Kroger, Nicolaus [Auteur]

Journal title :

Haematologica

Abbreviated title :

Haematologica

Volume number :

103

Pages :

237-245

Publication date :

2018-02-01

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

No standard exists for the treatment of myelodysplastic syndrome relapsing after allogeneic stem cell transplantation. We performed a retrospective registry analysis of outcomes and risk factors in 698 patients, treated ...
Show more >No standard exists for the treatment of myelodysplastic syndrome relapsing after allogeneic stem cell transplantation. We performed a retrospective registry analysis of outcomes and risk factors in 698 patients, treated with different strategies. The median overall survival from relapse was 4.7 months (95% confidence interval: 4.1-5.3) and the 2-year survival rate was 17.7% (95% confidence interval: 14.8-21.2%). Shorter remission after transplantation (P<0.001), advanced disease (P=0.001), older age (P=0.007), unrelated donor (P=0.008) and acute graft-versus-host disease before relapse (P<0.001) adversely influenced survival. At 6 months from relapse, patients had received no cellular treatment, (i.e. palliative chemotherapy or best supportive care, n=375), donor lymphocyte infusion (n=213), or a second transplant (n=110). Treatment groups were analyzed separately because of imbalanced characteristics and difficulties in retrospectively evaluating the reason for individual treatments. Of the patients who did not receive any cellular therapy, 109 were alive at 6 months after relapse, achieving a median overall survival from this landmark of 8.9 months (95% confidence interval: 5.1-12.6). Their 2-year survival rate was 29.7%. Recipients of donor lymphocytes achieved a median survival from first infusion of 6.0 months (95% confidence interval: 3.7-8.3) with a 2-year survival rate of 27.6%. Longer remission after first transplantation (P<0.001) and younger age (P=0.009) predicted better outcome. Among recipients of a second transplant, the median survival from second transplantation was 4.2 months (95% confidence interval: 2.5-5.9), and their 2-year survival rate was 17.0%. Longer remission after first transplantation (P<0.001), complete remission at second transplant (P=0.008), no prior chronic graft-versus-host disease (P<0.001) and change to a new donor (P=0.04) predicted better outcome. The data enabled identification of patients benefiting from donor lymphocyte infusion and second transplantation, and may serve as a baseline for prospective trials.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Inserm
Université de Lille
CHU Lille

Collections :

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

Research team(s) :

Immunity, inflammation and fibrsis in auto and allo-reactivity

Submission date :

2019-03-01T14:09:31Z
2019-07-16T14:15:17Z
2024-01-16T07:49:56Z