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.
Mitja Nabergoj
,
Diderik-Jan Eikema
(1)
,
Linda Koster
(1)
,
Uwe Platzbecker
(2)
,
Katja Sockel
(3)
,
Jürgen Finke
(4)
,
Nicolaus Kröger
(5)
,
Edouard Forcade
(6)
,
Arnon Nagler
(7)
,
Matthias Eder
(8)
,
Johanna Tischer
,
Annoek E. C. Broers
,
Jürgen Kuball
(9)
,
Keith M. O. Wilson
(10)
,
Mathilde Hunault-Berger
(11)
,
Matthew Collin
(12)
,
Domenico Russo
(13)
,
Lucía López Corral
(14)
,
Grzegorz Helbig
(15)
,
Alberto Mussetti
,
Christof Scheid
,
Carmelo Gurnari
(16)
,
Kavita Raj
(17)
,
Joanna Drozd-Sokolowska
(18)
,
Ibrahim Yakoub-Agha
(19)
,
Marie Robin
(20)
,
Donal P. Mclornan
(17)
1
Universiteit Leiden = Leiden University
2 University Hospital Leipzig = Universitätsklinikum Leipzig
3 University Hospital Carl Gustav Carus [Dresden, Germany]
4 University of Freiburg [Freiburg]
5 UKE - Universitaetsklinikum Hamburg-Eppendorf = University Medical Center Hamburg-Eppendorf [Hamburg]
6 CHU Bordeaux
7 Chaim Sheba Medical Center
8 MHH - Medizinische Hochschule Hannover = Hannover Medical School
9 UMCU - University Medical Center [Utrecht]
10 Cardiff University
11 CHU Angers - Centre Hospitalier Universitaire d'Angers
12 Newcastle University [Newcastle]
13 UniBs - Università degli Studi di Brescia = University of Brescia
14 Universidad de Salamanca = University of Salamanca
15 Silesian Medical University, Katowice, Poland
16 Università degli Studi di Roma Tor Vergata [Roma, Italia] = University of Rome Tor Vergata [Rome, Italy] = Université de Rome Tor Vergata [Rome, Italie]
17 UCLH - University College London Hospitals NHS Foundation Trust [London, UK]
18 Medical University of Warsaw - Poland
19 LIRIC - Lille Inflammation Research International Center - U 995
20 UPCité - Université Paris Cité
2 University Hospital Leipzig = Universitätsklinikum Leipzig
3 University Hospital Carl Gustav Carus [Dresden, Germany]
4 University of Freiburg [Freiburg]
5 UKE - Universitaetsklinikum Hamburg-Eppendorf = University Medical Center Hamburg-Eppendorf [Hamburg]
6 CHU Bordeaux
7 Chaim Sheba Medical Center
8 MHH - Medizinische Hochschule Hannover = Hannover Medical School
9 UMCU - University Medical Center [Utrecht]
10 Cardiff University
11 CHU Angers - Centre Hospitalier Universitaire d'Angers
12 Newcastle University [Newcastle]
13 UniBs - Università degli Studi di Brescia = University of Brescia
14 Universidad de Salamanca = University of Salamanca
15 Silesian Medical University, Katowice, Poland
16 Università degli Studi di Roma Tor Vergata [Roma, Italia] = University of Rome Tor Vergata [Rome, Italy] = Université de Rome Tor Vergata [Rome, Italie]
17 UCLH - University College London Hospitals NHS Foundation Trust [London, UK]
18 Medical University of Warsaw - Poland
19 LIRIC - Lille Inflammation Research International Center - U 995
20 UPCité - Université Paris Cité
Mitja Nabergoj
- Fonction : Auteur
Johanna Tischer
- Fonction : Auteur
Annoek E. C. Broers
- Fonction : Auteur
Alberto Mussetti
- Fonction : Auteur
Christof Scheid
- Fonction : Auteur
Résumé
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.