TY - JOUR
T1 - Hematopoietic stem cell transplantation for therapy-related myelodysplastic syndrome and acute leukemia
T2 - A single-center analysis of 47 patients
AU - Yokoyama, Hiroki
AU - Mori, Shin Ichiro
AU - Kobayashi, Yukio
AU - Kurosawa, Saiko
AU - Saito, Bungo
AU - Fuji, Shigeo
AU - Maruyama, Dai
AU - Azuma, Teruhisa
AU - Kim, Sung Won
AU - Watanabe, Takashi
AU - Tanosaki, Ryuji
AU - Tobinai, Kensei
AU - Takaue, Yoichi
AU - Fukuda, Takahiro
N1 - Funding Information:
Acknowledgments This work was supported in part by grants from the Ministry of Health, Labor and Welfare, Japan, and grants from the Advanced Clinical Research Organization. We thank the medical, nursing, data processing, and laboratory staffs at National Cancer Center Hospital for their important contributions to this study through dedicated care of the patients.
PY - 2010/9
Y1 - 2010/9
N2 - The prognosis of therapy-related myelodysplastic syndrome and acute leukemia (t-MDS/AL) remains poor. We retrospectively analyzed the data of 47 patients (31 AL and 16 MDS) who were treated at our institute. Thirty-three patients received disease-adapted chemotherapy, with a response rate of 73%, while 14 received no interventions due to an indolent course, such as MDS. The median follow-up of surviving patients was 1.9 years (range 0.1-10.5) after the diagnosis of t-MDS/AL, and the estimated 3-year overall survival (OS) for all patients was 55%. Twenty-seven patients underwent allogeneic hematopoietic stem cell transplantation (HCT), and the 3-year non-relapse mortality was 17%. Twenty patients did not undergo HCT due to various reasons including advanced age or comorbidities. The 3-year OS was better in patients who received HCT than in those who did not (71 vs. 31%; p = 0.018). A multivariate analysis revealed that HCT was associated with a better OS. Although this study has several limitations, including a potential selection bias due to the retrospective nature of the analysis and a small number of patients, the results show that modern HCT may be useful for inducing long-term survival in a fraction of patients suffering from t-MDS/AL. The present findings warrant future prospective studies.
AB - The prognosis of therapy-related myelodysplastic syndrome and acute leukemia (t-MDS/AL) remains poor. We retrospectively analyzed the data of 47 patients (31 AL and 16 MDS) who were treated at our institute. Thirty-three patients received disease-adapted chemotherapy, with a response rate of 73%, while 14 received no interventions due to an indolent course, such as MDS. The median follow-up of surviving patients was 1.9 years (range 0.1-10.5) after the diagnosis of t-MDS/AL, and the estimated 3-year overall survival (OS) for all patients was 55%. Twenty-seven patients underwent allogeneic hematopoietic stem cell transplantation (HCT), and the 3-year non-relapse mortality was 17%. Twenty patients did not undergo HCT due to various reasons including advanced age or comorbidities. The 3-year OS was better in patients who received HCT than in those who did not (71 vs. 31%; p = 0.018). A multivariate analysis revealed that HCT was associated with a better OS. Although this study has several limitations, including a potential selection bias due to the retrospective nature of the analysis and a small number of patients, the results show that modern HCT may be useful for inducing long-term survival in a fraction of patients suffering from t-MDS/AL. The present findings warrant future prospective studies.
KW - Acute leukemia
KW - Therapy-related myelodysplastic syndrome
KW - Transplantation
UR - http://www.scopus.com/inward/record.url?scp=77956894757&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77956894757&partnerID=8YFLogxK
U2 - 10.1007/s12185-010-0640-7
DO - 10.1007/s12185-010-0640-7
M3 - Article
C2 - 20680530
AN - SCOPUS:77956894757
SN - 0925-5710
VL - 92
SP - 334
EP - 341
JO - International journal of hematology
JF - International journal of hematology
IS - 2
ER -