Allogeneic haematopoietic cell transplantation for therapy-related myeloid neoplasms arising following treatment for lymphoma: a retrospective study on behalf of the Chronic Malignancies Working Party of the EBMT

TY - JOUR

T1 - Allogeneic haematopoietic cell transplantation for therapy-related myeloid neoplasms arising following treatment for lymphoma: a retrospective study on behalf of the Chronic Malignancies Working Party of the EBMT

AU - Nabergoj, Mitja

AU - Eikema, Diderik-Jan

AU - Koster, Linda

AU - Platzbecker, Uwe

AU - Sockel, Katja

AU - Finke, Jürgen

AU - Kröger, Nicolaus

AU - Forcade, Edouard

AU - Nagler, Arnon

AU - Eder, Matthias

AU - Tischer, Johanna

AU - Broers, Annoek E C

AU - Kuball, Jürgen

AU - Wilson, Keith M O

AU - Hunault-Berger, Mathilde

AU - Collin, Matthew

AU - Russo, Domenico

AU - Corral, Lucía López

AU - Helbig, Grzegorz

AU - Mussetti, Alberto

AU - Scheid, Christof

AU - Gurnari, Carmelo

AU - Raj, Kavita

AU - Drozd-Sokolowska, Joanna

AU - Yakoub-Agha, Ibrahim

AU - Robin, Marie

AU - McLornan, Donal P

N1 - © 2024. The Author(s), under exclusive licence to Springer Nature Limited.

PY - 2024/3

Y1 - 2024/3

N2 - Therapy-related myeloid neoplasms (t-MN), either myelodysplastic neoplasms (t-MDS) or acute myeloid leukemias (t-AML), have a poor prognosis and allogeneic haematopoietic cell transplantation (allo-HCT) represents the only curative option. In this multicenter, registry-based study, we analyzed outcomes of 378 patients undergoing first allo-HCT between 2006-2017 for t-MN arising secondary to lymphoma treatment. Median age was 58 years at allo-HCT; 222 (59%) had a diagnosis of t-MDS and 156 (41%) of t-AML, respectively. At the time of allo-HCT, 46% of t-MN cases were reported as in complete remission (CR) and 15% of lymphomas were recorded as not in remission. A reduced intensity conditioning regimen was used in 70% of cases. For the entire cohort, 5-year OS, and t-MN PFS, relapse incidence and NRM were 32%, 28%, 35% and 37%, respectively. In multivariable analysis, undergoing allo-HCT with t-MN not in CR and older age were associated with significantly worse OS, PFS and NRM. At 5 years post allo-HCT, the relapse incidence of lymphoma was low at 3%, while the rate of secondary malignancies was 8%. This analysis shows the curative potential of allo-HCT for patients with t-MN arising secondary to lymphoma treatment in approximately a third of patients.

AB - Therapy-related myeloid neoplasms (t-MN), either myelodysplastic neoplasms (t-MDS) or acute myeloid leukemias (t-AML), have a poor prognosis and allogeneic haematopoietic cell transplantation (allo-HCT) represents the only curative option. In this multicenter, registry-based study, we analyzed outcomes of 378 patients undergoing first allo-HCT between 2006-2017 for t-MN arising secondary to lymphoma treatment. Median age was 58 years at allo-HCT; 222 (59%) had a diagnosis of t-MDS and 156 (41%) of t-AML, respectively. At the time of allo-HCT, 46% of t-MN cases were reported as in complete remission (CR) and 15% of lymphomas were recorded as not in remission. A reduced intensity conditioning regimen was used in 70% of cases. For the entire cohort, 5-year OS, and t-MN PFS, relapse incidence and NRM were 32%, 28%, 35% and 37%, respectively. In multivariable analysis, undergoing allo-HCT with t-MN not in CR and older age were associated with significantly worse OS, PFS and NRM. At 5 years post allo-HCT, the relapse incidence of lymphoma was low at 3%, while the rate of secondary malignancies was 8%. This analysis shows the curative potential of allo-HCT for patients with t-MN arising secondary to lymphoma treatment in approximately a third of patients.

U2 - 10.1038/s41409-023-02193-z

DO - 10.1038/s41409-023-02193-z

M3 - SCORING: Journal article

C2 - 38195984

VL - 59

SP - 395

EP - 402

JO - BONE MARROW TRANSPL

JF - BONE MARROW TRANSPL

SN - 0268-3369

IS - 3

ER -