Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Letter to the Editor
  • Published:

Autologous HSC transplant in t-MDS/AML using cells harvested prior to the development of the secondary malignancy

Bone Marrow Transplantation volume 42, pages 497–498 (2008)Cite this article

Therapy-related myelodysplastic syndrome (MDS)/AML (t-MDS/AML) is a common and devastating complication of treatment with alkylating agents and topoisomerase II inhibitors, often employed with curative intent, in standard or high doses, in the treatment of hematological malignancies and solid tumors. Allogeneic hematopoietic stem cell (HSC) transplant is considered the best treatment for t-MDS/AML1 but its use is limited by the unavailability of donors, comorbidities in the recipient and risk of acute and chronic GVHD. The results of autologous HSC transplantation in t-MDS/AML are poor with an excessive rate of relapse;2 likely reflecting the infusion of an HSC product carrying the same molecular abnormalities responsible for the development of the t-MDS/AML in the first place.

Patients with malignancies commonly treated with high-dose chemotherapy and autologous HSC transplant (such as multiple myeloma and non-Hodgkin's lymphoma) who later develop t-MDS/AML occasionally undergo HSC transplant with stored HSC harvested prior to the diagnosis of the secondary malignancy (early-stored HSC) for the purpose of a future transplant to either consolidate an initial response or to be employed as salvage therapy for the primary malignancy. Such cells are theoretically less likely to carry the molecular ‘hits’ implicated in t-MDS/AML3 than HSC harvested in first complete remission of the secondary malignancy. Another advantage is the prompt availability of the HSC product, avoiding the delay in the transplant process and toxicity caused by HSC mobilization and harvesting. Autologous HSC transplant utilizing a prestored product may therefore be an interesting option for patients with t-MDS/AML who lack an adequate HSC donor or are poor candidates to an allograft.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

References

  1. Larson RA . Etiology and management of therapy-related myeloid leukemia. Hematology Am Soc Hematol Educ Program 2007; 2007: 453–459.

    Article  Google Scholar 

  2. Kroger N, Brand R, van Biezen A, Cahn JY, Slavin S, Blaise D et al. Autologous stem cell transplantation for therapy-related acute myeloid leukemia and myelodysplastic syndrome. Bone Marrow Transplant 2006; 37: 183–189.

    Article  CAS  PubMed  Google Scholar 

  3. Lillington DM, Micallef IN, Carpenter E, Neat MJ, Amess JA, Matthews J et al. Detection of chromosome abnormalities pre-high-dose treatment in patients developing therapy-related myelodysplasia and secondary acute myelogenous leukemia after treatment for non-Hodgkin's lymphoma. J Clin Oncol 2001; 19: 2472–2481.

    Article  CAS  PubMed  Google Scholar 

  4. Rodriguez V, Erlandson L, Arndt CA, Wiseman GA, Anderson PM . Low toxicity and efficacy of (153)samarium-EDTMP and melphalan as a conditioning regimen for secondary acute myelogenous leukemia. Pediatr Transplant 2005; 9: 122–126.

    Article  PubMed  Google Scholar 

  5. Smith SM, Le Beau MM, Huo D, Karrison T, Sobecks RM, Anastasi J et al. Clinical-cytogenetic associations in 306 patients with therapy-related myelodysplasia and myeloid leukemia: the University of Chicago series. Blood 2003; 102: 43–52.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN, USA

    L J Costa, V Rodriguez, L F Porrata, M Q Lacy, M A Elliott, M A Gertz, D A Gastineau & M R Litzow

Authors
  1. L J Costa
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. V Rodriguez
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. L F Porrata
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M Q Lacy
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. M A Elliott
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. M A Gertz
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. D A Gastineau
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. M R Litzow
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to L J Costa.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Costa, L., Rodriguez, V., Porrata, L. et al. Autologous HSC transplant in t-MDS/AML using cells harvested prior to the development of the secondary malignancy. Bone Marrow Transplant 42, 497–498 (2008). https://doi.org/10.1038/bmt.2008.194

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/bmt.2008.194

Search

Advanced search

Quick links