Allogeneic Stem Cell Transplantation in Therapy-Related Myelodysplasia after Autologous Transplantation for Lymphoma: A Retrospective Study of the Francophone Society of Bone Marrow Transplantation and Cellular Therapy

Jaimes-Albornoz, D.; Mannone, L.; Nguyen-Quoc, S.; Chalandon, Y.; Chevallier, P.; Mohty, M.; Meunier, M.; Robin, M.; Ledoux, M.-P.; Guillerm, G.; Bay, J.-O.; Poiré, X.; Maillard, N.; Leclerc, M.; Daguindau, E.; Beguin, Yves; Rubio, M. T.; Gyan, E.

doi:10.1016/j.bbmt.2019.07.013

Article (Scientific journals)

Allogeneic Stem Cell Transplantation in Therapy-Related Myelodysplasia after Autologous Transplantation for Lymphoma: A Retrospective Study of the Francophone Society of Bone Marrow Transplantation and Cellular Therapy

Jaimes-Albornoz, D.; Mannone, L.; Nguyen-Quoc, S. et al.

2019 • In Biology of Blood and Marrow Transplantation, 25, p. 2366-2374

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https://hdl.handle.net/2268/244744

DOI
10.1016/j.bbmt.2019.07.013

PubMed
31326611

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Keywords :

Allogeneic stem cell transplantation; Autologous stem cell transplantation; Lymphoma; Therapy-related myelodysplasia

Abstract :

[en] Therapy-related myelodysplastic syndrome (t-MDS) after autologous stem cell transplantation (ASCT) is a rare complication with no curative option. Allogeneic hematopoietic stem cell transplantation (allo-HSCT) may be considered for eligible patients and has been understudied in t-MDS. We report 47 consecutive patients with t-MDS after an ASCT who underwent allo-HSCT with a median age of 58 years (range, 30 to 71 years) at transplantation and a median follow-up of 22 months (range, 0.7 to 107). The median overall survival (OS) was 6.9 months (95% confidence interval [CI], 0 to 19 months). OS rates were 45% (29% to 60%) and 30% (15% to 45%) at 1 and 3 years after transplantation, respectively. On univariate analysis, prior therapy for t-MDS before allo-HSCT (P =.02) and mismatched donors (P =.004) were associated with poor OS. Three-year nonrelapse mortality (NRM) and relapse rates were 44% (25% to 63%) and 41% (22% to 61%), respectively. Mismatched donors (P <.001) were associated with higher NRM and a high-risk MDS (P =.008) with a higher relapse risk. On multivariate analysis, HLA mismatch was associated with higher NRM (hazard ratio, 6.21; 95% CI, 1.63 to 23.62; P =.007). In conclusion, our results suggest that one third of the patients who develop t-MDS after an ASCT for lymphoma are cured after an allo-HSCT. The use of mismatched donors with standard graft-versus-host disease prophylaxis should be avoided in such an indication for allo-HSCT. It will be worthwhile to see if the implementation of cyclophosphamide post-transplantation will improve the outcome with mismatched donors. © 2019 American Society for Transplantation and Cellular Therapy

Disciplines :

Hematology

Author, co-author :

Jaimes-Albornoz, D.; Department of Hematology and Cellular Therapy, Tours University Hospital, Tours, France

Mannone, L.; Department of Hematology, Nice University Hospital, Nice, France

Nguyen-Quoc, S.; Department of Hematology, Pitié Salpêtrière Hospital, AP-HP, Paris, France

Chalandon, Y.; Department of Hematology, Geneva University Hospital, Faculty of Medicine, University of Geneva, Geneva, Switzerland

Chevallier, P.; Department of Hematology, Nantes University Hospital, Nantes, France

Mohty, M.; Department of Hematology and Cellular Therapy, Saint-Antoine Hospital, AP-HP, Sorbonne University, UPMC Paris 06, INSERM, UMRS 938, Centre de Recherches Saint-Antoine, Paris, France

Meunier, M.; Department of Hematology, Grenoble University Hospital, Grenoble, France

Robin, M.; Department of Hematology, Saint-Louis Hospital, AP-HP, Paris, France

Ledoux, M.-P.; Department of Hematology, Strasbourg University Hospital, Strasbourg, France

Guillerm, G.; Department of Hematology, Brest University Hospital, Brest, France

More authors (8 more)

Language :

English

Title :

Publication date :

2019

Journal title :

Biology of Blood and Marrow Transplantation

ISSN :

1083-8791

eISSN :

1523-6536

Publisher :

Elsevier Inc.

Volume :

Pages :

2366-2374

Peer reviewed :

Peer Reviewed verified by ORBi

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since 13 February 2020

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