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Myelodisplasias

A retrospective comparison of autologous and unrelated donor hematopoietic cell transplantation in myelodysplastic syndrome and secondary acute myeloid leukemia: a report on behalf of the Chronic Leukemia Working Party of the European Group for Blood and Marrow Transplantation (EBMT)

Leukemia volume 21, pages 1945–1951 (2007)Cite this article

Abstract

Hematopoietic cell transplantation (HCT) is an effective treatment for myelodysplasia (MDS) and secondary acute myeloid leukemia (sAML). In this study, outcome of 593 patients with MDS/sAML after autologous and allogeneic HCT from a matched unrelated donor (MUD) were compared. A total of 167 (28%) patients received HCT from MUD without prior chemotherapy (MUD-U). The rest received HCT in first complete remission (CR1) (Autologous (Auto-CR1), n=290 (49%), HCT from MUD (MUD-CR1), n=136 (23%)). Survival at 3 years was best in MUD-CR1 (50%) compared to Auto-CR1 (41%) and MUD-U (40%) (P=0.01). Similarly, disease-free survival was 44% for MUD-CR1 compared to Auto-CR1 (28%) and MUD-U (34%) (P=0.03). Treatment-related mortality was 17% in Auto-CR1 compared to MUD-CR1 (38%) and MUD-U (49%) (P<0.001). Relapse for Auto-CR1 was 62% compared to 24 and 30% for MUD-CR1 and MUD-U, respectively (P<0.001). Outcome was best for patients with low tumor burden transplanted 6–12 months after diagnosis. Factors influencing outcome at 3 years were mainly significant in the first 6 months. Only, relapse after autologous HCT remained constant over time. Outcomes after allogeneic HCT in patients of 20–40 and >40 years were similar. Autologous and Allogeneic HCT from MUD offer the possibility of long-term survival to patients with MDS/sAML.

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Authors and Affiliations

  1. Department of Hematology/Oncology, University of Leipzig, Leipzig, Germany

    H K Al-Ali & D Niederwieser

  2. Department of Medical Statistics, Leiden University MC, Leiden, The Netherlands

    R Brand

  3. Chronic Leukemia Working Party Registry, Leiden, The Netherlands

    A van Biezen

  4. Department of Hematology, University of Freiburg, Freiburg, Germany

    J Finke

  5. Department of Hematology, University of Gasthuisberg, Leuven, Belgium

    M Boogaerts

  6. Department of Hematology, Klinik fuer Knochenmarktransplantation GmBH, Idar-Oberstein, Germany

    A A Fauser

  7. BMT Centre, University Hospital Leiden, Leiden, The Netherlands

    M Egeler

  8. Service d′ Hematologie, Hospital Jean Minjoz, Besancon, France

    J-Y Cahn

  9. Department of Hematology, Charite, Campus Virchow-Klinikum, Berlin, Germany

    R Arnold

  10. Bone Marrow Transplantation, University of Essen, Essen, Germany

    H Biersack

  11. Department of Hematology, University Medical Center St Radboud, Nijmegen, The Netherlands

    T de Witte

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  1. H K Al-Ali
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Al-Ali, H., Brand, R., van Biezen, A. et al. A retrospective comparison of autologous and unrelated donor hematopoietic cell transplantation in myelodysplastic syndrome and secondary acute myeloid leukemia: a report on behalf of the Chronic Leukemia Working Party of the European Group for Blood and Marrow Transplantation (EBMT). Leukemia 21, 1945–1951 (2007). https://doi.org/10.1038/sj.leu.2404774

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