Allogeneic hematopoietic cell transplantation in patients with therapy-related myeloid neoplasm after breast cancer: a study of the Chronic Malignancies Working Party of the EBMT.
[en] We performed a registry study on therapy-related myeloid neoplasm (t-MN), both therapy-related myelodysplastic syndrome (t-MDS) and acute myeloid leukemia (t-AML) following treatment for breast cancer who underwent a first allogeneic hematopoietic cell transplant (allo-HCT). Of 252 identified female patients (median age 57 years), 77% were transplanted for t-AML and 23% for t-MDS, with a median time from breast cancer diagnosis to the diagnosis of tMN and subsequent allo-HCT of 3.7 and 4.6 years, respectively. At transplant, 191 patients were in remission for breast cancer, while 4 were not (57 missing). T-MN was in a complete remission at the time of transplant in 67% of patients. 2-year overall survival, relapse free-survival, relapse incidence and non-relapse mortality were 50%, 45%, 33%, and 22%, respectively. Multivariable analysis revealed that if the t-MN was not in CR pre-transplant, this was associated with lower OS, RFS, and a higher relapse incidence. Seventeen cases of breast cancer recurrence were recorded after a median of 2.4 years post-transplant, and relapse of primary breast cancer accounted for 7% of deaths. This study indicates that allo-HCT for t-MN following treatment for breast cancer shows encouraging transplant outcomes. The incidence of breast cancer relapse post-transplant remains a cause for concern.
Disciplines :
Hematology
Author, co-author :
Nabergoj, Mitja ; Hematology Service, Institut Central des Hôpitaux (ICH), Hôpital du Valais, Sion, Switzerland. mitja.nabergoj@hopitalvs.ch
Mauff, Katya; EBMT Statistical Unit, Leiden, the Netherlands
Beelen, Dietrich; Department of Bone Marrow Transplantation, Universitätsklinikum Essen, Essen, Germany
Ganser, Arnold; Department of Hematology, Hemostasis, Oncology, and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
Kröger, Nicolaus ; University Hospital Eppendorf, Hamburg, Germany
Stölzel, Friedrich; Medizinische Klinik und Poliklinik I, University Hospital Carl Gustav Carus Dresden, Technical University Dresden, Dresden, Germany
Finke, Jürgen ; Department of Hematology, Oncology and Stem Cell Transplantation, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
Passweg, Jakob; University Hospital, Basel, Switzerland
Cornelissen, Jan; Department of Hematology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, the Netherlands
Schub, Natalie; Division for Stem Cell Transplantation and Immunotherapy, University Hospital of Schleswig-Holstein, Kiel, Germany
Veelken, Joan Hendrik ; Department of Hematology, Leiden University Medical Center, Leiden, the Netherlands
Beguin, Yves ; Centre Hospitalier Universitaire de Liège - CHU > > Service d'hématologie clinique
Wilson, Keith; Department of Hematology, University Hospital of Wales, Heath Park, Cardiff, Wales, UK
Zuckerman, Tsila ; Department of Hematology and Bone Marrow Transplantation, Rambam Health Care Campus, Haifa, Israel
Hunault-Berger, Mathilde ; CHRU Angers, Angers, France
Lioure, Bruno; Department of Hematology, ICANS, Strasbourg, France
Porras, Rocio Parody; Deparment of Clinical Hematalogy, ICO-Hospital Duran i Reynals, Barcelona, Spain
Turlure, Pascal; Service d'Hématologie Clinique et Thérapie Cellulaire, Centre Hospitalier Universitaire, Limoges, France
Kerre, Tessa; Department of Hematology, Ghent University Hospital, Ghent, Belgium
Koster, Linda; EBMT Date Office, Leiden, the Netherlands
Hayden, Patrick J; Department of Hematology, Trinity College Dublin, St. James's Hospital, Dublin, Ireland
Onida, Francesco ; Hematology-BMT Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico-University of Milan, Milan, Italy
Scheid, Christof; University Hospital Koeln, Cologne, Germany
Chalandon, Yves ; Division of Hematology, Hôpitaux Universitaires de Genève and Faculty of Medicine, University of Geneva, Geneva, Switzerland
Robin, Marie ; Hôpital Saint-Louis, APHP, Université Paris 7, Paris, France
Yakoub-Agha, Ibrahim ; CHU de Lille, Univ Lille, INSERM U1286, INFINITE, 59000, Lille, France. ibrahim.yakoubagha@chru-lille.fr
Allogeneic hematopoietic cell transplantation in patients with therapy-related myeloid neoplasm after breast cancer: a study of the Chronic Malignancies Working Party of the EBMT.
Ferlay J, Ervik M, Lam F, Colombet M, Mery L, Piñeros M, et al. (2020). Global cancer observatory: cancer today. Lyon, France: International Agency for Research on Cancer. https://gco.iarc.fr/today, Accessed 1 Feb 2021.
Miller KD, Nogueira L, Mariotto AB, Rowland JH, Yabroff KR, Alfano CM, et al. Cancer treatment and survivorship statistics, 2019. CA Cancer J Clin. 2019;69:363–85. DOI: 10.3322/caac.21565
Shapiro CL, Recht A. Side effects of adjuvant treatment of breast cancer. Wood AJJ, éditeur. N Engl J Med. 2001;344:1997–2008. DOI: 10.1056/NEJM200106283442607
Carter J, Lacchetti C, Andersen BL, Barton DL, Bolte S, Damast S, et al. Interventions to address sexual problems in people with cancer: American Society of Clinical Oncology Clinical Practice Guideline Adaptation of Cancer Care Ontario Guideline. J Clin Oncol. 2018;36:492–511. DOI: 10.1200/JCO.2017.75.8995
Curigliano G, Cardinale D, Suter T, Plataniotis G, de Azambuja E, Sandri MT, et al. Cardiovascular toxicity induced by chemotherapy, targeted agents and radiotherapy: ESMO clinical practice guidelines. Ann Oncol. 2012;23:vii155–66. DOI: 10.1093/annonc/mds293
Morton LM, Dores GM, Schonfeld SJ, Linet MS, Sigel BS, Lam CJK. et al. Association of chemotherapy for solid tumors with development of therapy-related myelodysplastic syndrome or acute myeloid leukemia in the modern era. JAMA Oncol.2019;5:318. DOI: 10.1001/jamaoncol.2018.5625
Arber DA, Orazi A, Hasserjian R, Thiele J, Borowitz MJ, Le Beau MM, et al. The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia. Blood. 2016;127:2391–405. DOI: 10.1182/blood-2016-03-643544
Guru Murthy GS, Hamadani M, Dhakal B, Hari P, Atallah E. Incidence and survival of therapy related myeloid neoplasm in United States. Leuk Res. 2018;71:95–9. DOI: 10.1016/j.leukres.2018.07.013
Wolff AC, Blackford AL, Visvanathan K, Rugo HS, Moy B, Goldstein LJ, et al. Risk of marrow neoplasms after adjuvant breast cancer therapy: the national comprehensive cancer network experience. J Clin Oncol. 2015;33:340–8. DOI: 10.1200/JCO.2013.54.6119
Curtis RE, Boice JD, Stovall M, Bernstein L, Greenberg RS, Flannery JT, et al. Risk of leukemia after chemotherapy and radiation treatment for breast cancer. N Engl J Med. 1992;326:1745–51. DOI: 10.1056/NEJM199206253262605
Granfeldt Østgård LS, Medeiros BC, Sengeløv H, Nørgaard M, Andersen MK, Dufva IH, et al. Epidemiology and clinical significance of secondary and therapy-related acute myeloid leukemia: a national population-based cohort study. J Clin Oncol. 2015;33:3641–9. DOI: 10.1200/JCO.2014.60.0890
Kayser S, Döhner K, Krauter J, Köhne C-H, Horst HA, Held G, et al. The impact of therapy-related acute myeloid leukemia (AML) on outcome in 2853 adult patients with newly diagnosed AML. Blood. 2011;117:2137–45. DOI: 10.1182/blood-2010-08-301713
Borthakur G, Lin E, Jain N, Estey EE, Cortes JE, O’Brien S, et al. Survival is poorer in patients with secondary core-binding factor acute myelogenous leukemia compared with de novo core-binding factor leukemia. Cancer. 2009;115:3217–21. DOI: 10.1002/cncr.24367
Fianchi L, Pagano L, Piciocchi A, Candoni A, Gaidano G, Breccia M, et al. Characteristics and outcome of therapy-related myeloid neoplasms: report from the Italian network on secondary leukemias: Italian t-MN Report. Am J Hematol. 2015;90:E80–5. DOI: 10.1002/ajh.23966
Rogers HJ, Wang X, Xie Y, Davis AR, Thakral B, Wang SA, et al. Comparison of therapy-related and de novo core binding factor acute myeloid leukemia: a bone marrow pathology group study. Am J Hematol. 2020;95:799–808. DOI: 10.1002/ajh.25814
Lancet JE, Uy GL, Cortes JE, Newell LF, Lin TL, Ritchie EK, et al. CPX-351 (cytarabine and daunorubicin) liposome for injection versus conventional cytarabine plus daunorubicin in older patients with newly diagnosed secondary acute myeloid leukemia. J Clin Oncol. 2018;36:2684–92. DOI: 10.1200/JCO.2017.77.6112
Morsia E, McCullough K, Joshi M, Cook J, Alkhateeb HB, Al-Kali A, et al. Venetoclax and hypomethylating agents in acute myeloid leukemia: Mayo Clinic series on 86 patients. Am J Hematol. 2020;95:1511–21. DOI: 10.1002/ajh.25978
Borate U, Norris BA, Statler A, Fu R, Bucy T, Sekeres MA. Representation of therapy-related myelodysplastic syndrome in clinical trials over the past 20 years. Blood Adv. 2019;3:2738–47. DOI: 10.1182/bloodadvances.2019000293
Michelis FV, Atenafu EG, Gupta V, Kim DD, Kuruvilla J, Lipton JH, et al. Comparable outcomes post allogeneic hematopoietic cell transplant for patients with de novo or secondary acute myeloid leukemia in first remission. Bone Marrow Transplant. 2015;50:907–13. DOI: 10.1038/bmt.2015.59
Döhner H, Estey E, Grimwade D, Amadori S, Appelbaum FR, Büchner T, et al. Diagnosis and management of AML in adults: 2017 ELN recommendations from an international expert panel. Blood. 2017;129:424–47. DOI: 10.1182/blood-2016-08-733196
Sorror ML, Maris MB, Storb R, Baron F, Sandmaier BM, Maloney DG, et al. Hematopoietic cell transplantation (HCT)-specific comorbidity index: a new tool for risk assessment before allogeneic HCT. Blood. 2005;106:2912–9. DOI: 10.1182/blood-2005-05-2004
Maajani K, Jalali A, Alipour S, Khodadost M, Tohidinik HR, Yazdani K. The global and regional survival rate of women with breast cancer: a systematic review and meta-analysis. Clin Breast Cancer. 2019;19:165–77. DOI: 10.1016/j.clbc.2019.01.006
Cancer Research UK (2021), Breast cancer statistics, Cancer Research UK.
American Cancer Society. Cancer facts & figures 2021. Atlanta, GA: American Cancer Society; 2021.
Schmaelter A-K, Labopin M, Socié G, Itälä-Remes M, Blaise D, Yakoub-Agha I, et al. Inferior outcome of allogeneic stem cell transplantation for secondary acute myeloid leukemia in first complete remission as compared to de novo acute myeloid leukemia. Blood Cancer J Mars. 2020;10:26. DOI: 10.1038/s41408-020-0296-3
Metheny L, Callander NS, Hall AC, Zhang MJ, Bo-Subait K, Wang HL, et al. Allogeneic Transplantation to Treat Therapy-Related Myelodysplastic Syndrome and Acute Myelogenous Leukemia in Adults. Transplant Cell Ther. 2021;27:923.e1–923.e12.
Jentzsch M, Grimm J, Bill M, Brauer D, Backhaus D, Goldmann K, et al. ELN risk stratification and outcomes in secondary and therapy-related AML patients consolidated with allogeneic stem cell transplantation. Bone Marrow Transplant. 2021;56:936–45.
Kroger N, Brand R, van Biezen A, Zander A, Dierlamm J, Niederwieser D, et al. Risk factors for therapy-related myelodysplastic syndrome and acute myeloid leukemia treated with allogeneic stem cell transplantation. Haematologica. 2009;94:542–9. DOI: 10.3324/haematol.2008.000927
Gatwood KS, Labopin M, Savani BN, Finke J, Socie G, Beelen D, et al. Transplant outcomes for patients with therapy-related acute myeloid leukemia with prior lymphoid malignancy: an ALWP of EBMT study. Bone Marrow Transplant 2020;55:224–32. DOI: 10.1038/s41409-019-0673-3
Lee CJ, Labopin M, Beelen D, Finke J, Blaise D, Ganser A, et al. Comparative outcomes of myeloablative and reduced-intensity conditioning allogeneic hematopoietic cell transplantation for therapy-related acute myeloid leukemia with prior solid tumor: a report from the acute leukemia working party of the European society for blood and bone marrow transplantation. Am J Hematol. 2019;94:431–8. DOI: 10.1002/ajh.25395
Cheng L, Swartz MD, Zhao H, Kapadia AS, Lai D, Rowan PJ, et al. Hazard of recurrence among women after primary breast cancer treatment—a 10-year follow-up using data From SEER-medicare. Cancer Epidemiol Biomark Prev. 2012;21:800–9. DOI: 10.1158/1055-9965.EPI-11-1089
