Late treatment-related mortality versus competing causes of death after allogeneic transplantation for myelodysplastic syndromes and secondary acute myeloid leukemia
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Late treatment-related mortality versus competing causes of death after allogeneic transplantation for myelodysplastic syndromes and secondary acute myeloid leukemia. / Schetelig, Johannes; de Wreede, Liesbeth C; van Gelder, Michel; Koster, Linda; Finke, Jürgen; Niederwieser, Dietger; Beelen, Dietrich; Mufti, G J; Platzbecker, Uwe; Ganser, Arnold; Heidenreich, Silke; Maertens, Johan; Socié, Gerard; Brecht, Arne; Stelljes, Matthias; Kobbe, Guido; Volin, Liisa; Nagler, Arnon; Vitek, Antonin; Luft, Thomas; Ljungman, Per; Yakoub-Agha, Ibrahim; Robin, Marie; Kröger, Nicolaus.
In: LEUKEMIA, Vol. 33, No. 3, 03.2019, p. 686-695.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Late treatment-related mortality versus competing causes of death after allogeneic transplantation for myelodysplastic syndromes and secondary acute myeloid leukemia
AU - Schetelig, Johannes
AU - de Wreede, Liesbeth C
AU - van Gelder, Michel
AU - Koster, Linda
AU - Finke, Jürgen
AU - Niederwieser, Dietger
AU - Beelen, Dietrich
AU - Mufti, G J
AU - Platzbecker, Uwe
AU - Ganser, Arnold
AU - Heidenreich, Silke
AU - Maertens, Johan
AU - Socié, Gerard
AU - Brecht, Arne
AU - Stelljes, Matthias
AU - Kobbe, Guido
AU - Volin, Liisa
AU - Nagler, Arnon
AU - Vitek, Antonin
AU - Luft, Thomas
AU - Ljungman, Per
AU - Yakoub-Agha, Ibrahim
AU - Robin, Marie
AU - Kröger, Nicolaus
PY - 2019/3
Y1 - 2019/3
N2 - The causes and rates of late patient-mortality following alloHCT for myelodysplastic syndromes or secondary acute myeloid leukemia were studied, to assess the contribution of relapse-related, treatment-related, and population factors. Data from EBMT on 6434 adults, who received a first alloHCT from January 2000 to December 2012, were retrospectively studied using combined land-marking, relative-survival methods and multi-state modeling techniques. Median age at alloHCT increased from 49 to 58 years, and the number of patients aged ≥65 years at alloHCT increased from 5 to 17%. Overall survival probability was 53% at 2 years and 35% at 10 years post-alloHCT. Survival probability at 5 years from the 2-year landmark was 88% for patients <45-year old and 63% for patients ≥65-year old at alloHCT. Cumulative incidence of nonrelapse mortality (NRM) for patients <45-year old at transplant was 7% rising to 25% for patients aged ≥65. For older patients, 31% of NRM-deaths could be attributed to population mortality. Favorable post-alloHCT long-term survival was seen; however, excess mortality-risk for all age groups was shown compared to the general population. A substantial part of total NRM for older patients was attributable to population mortality, information which aids the balanced explanation of post-HCT risk and helps improve long-term care.
AB - The causes and rates of late patient-mortality following alloHCT for myelodysplastic syndromes or secondary acute myeloid leukemia were studied, to assess the contribution of relapse-related, treatment-related, and population factors. Data from EBMT on 6434 adults, who received a first alloHCT from January 2000 to December 2012, were retrospectively studied using combined land-marking, relative-survival methods and multi-state modeling techniques. Median age at alloHCT increased from 49 to 58 years, and the number of patients aged ≥65 years at alloHCT increased from 5 to 17%. Overall survival probability was 53% at 2 years and 35% at 10 years post-alloHCT. Survival probability at 5 years from the 2-year landmark was 88% for patients <45-year old and 63% for patients ≥65-year old at alloHCT. Cumulative incidence of nonrelapse mortality (NRM) for patients <45-year old at transplant was 7% rising to 25% for patients aged ≥65. For older patients, 31% of NRM-deaths could be attributed to population mortality. Favorable post-alloHCT long-term survival was seen; however, excess mortality-risk for all age groups was shown compared to the general population. A substantial part of total NRM for older patients was attributable to population mortality, information which aids the balanced explanation of post-HCT risk and helps improve long-term care.
KW - Journal Article
U2 - 10.1038/s41375-018-0302-y
DO - 10.1038/s41375-018-0302-y
M3 - SCORING: Journal article
C2 - 30573777
VL - 33
SP - 686
EP - 695
JO - LEUKEMIA
JF - LEUKEMIA
SN - 0887-6924
IS - 3
ER -