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

Haematologica
Christoph SchmidNikolaus Kröger

Abstract

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%. Rec...Continue Reading

Citations

Mar 17, 2018·Expert Review of Hematology·Guido KobbeUlrich Germing
Aug 21, 2018·Current Opinion in Oncology·Juan MontoroManuel Guerreiro
Jul 20, 2019·Expert Review of Hematology·Guido KobbeUlrich Germing
Jul 30, 2019·Expert Review of Hematology·Ulrich GermingNorbert Gattermann
Jan 11, 2019·International Journal of Molecular Sciences·Christina RautenbergThomas Schroeder
Jan 13, 2021·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Christoph SchmidGesine Bug
Nov 5, 2019·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Guang-Shing ChengAnne Bergeron
Feb 25, 2020·Hematology/oncology Clinics of North America·Eric S Winer
Oct 30, 2021·Leukemia & Lymphoma·Ibrahim AldossStephen J Forman
Feb 1, 2022·Journal of Cancer Research and Clinical Oncology·Maximilian FleischmannUlf Schnetzke

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Methods Mentioned

BETA
MDS

Software Mentioned

SPSS
survival
cmprsk
R
mstate

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