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Allografting

Survival benefits with transplantation in secondary AML evolving from myelodysplastic syndrome with hypomethylating treatment failure

Bone Marrow Transplantation volume 48, pages 678–683 (2013)Cite this article

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Abstract

The prognosis for patients with myelodysplastic syndrome with hypomethylating treatment failure (MDS-HTF) has been known to be poor. However, the clinical outcomes and optimal treatment options for secondary AML evolving from MDS-HTF (sAML/MDS-HTF) are not well known. This retrospective analysis was conducted to evaluate the clinical outcomes and influences of treatment options on survival in 46 consecutive patients with sAML/MDS-HTF. The median OS rates were 1.4 months in the best supportive care group (n=15) and 9.4 months in the active treatment group (n=31). One-year OS rates were 13.3% and 36.8%, respectively (P=0.001). Active treatment (P<0.001), lower BM blast (<33%) at sAML (P=0.007), non-poor NCCN (National Cancer Comprehensive Network) cytogenetics (P=0.001) and good performance status (ECOG (Eastern Cooperative Oncology Group) ⩽1) (P=0.024) were significant predictors affecting favorable OS in a multivariate analysis. Of the active treatment options, allo-SCT with prior chemotherapy (CTx) showed better OS compared with CTx only or SCT without CTx (P=0.019). Our analyses suggest that active treatment, particularly SCT following CTx, should be considered in patients with sAML/MDS-HTF if the patient is medically fit.

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Acknowledgements

We acknowledge all members of the Catholic Blood and Marrow Transplantation Center, particularly the house staff, for their excellent patient care. This study was sponsored by a research fund from Sanofi Cooperation.

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Authors and Affiliations

  1. Department of Hematology, Catholic Blood and Marrow Transplantation Center, Seoul St Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

    S-H Shin, S-A Yahng, J-H Yoon, S-E Lee, B-S Cho, K-S Eom, S Lee, C-K Min, H-J Kim, S-G Cho, D-W Kim, J-W Lee, W-S Min, C-W Park & Y-J Kim

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  1. S-H Shin
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Correspondence to Y-J Kim.

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Competing interests

Dr Yoo-Jin Kim has received honoraria and clinical research support from the Jassen, Celgene and Sanofi Cooperation. The other authors declare no conflict of interest.

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Shin, SH., Yahng, SA., Yoon, JH. et al. Survival benefits with transplantation in secondary AML evolving from myelodysplastic syndrome with hypomethylating treatment failure. Bone Marrow Transplant 48, 678–683 (2013). https://doi.org/10.1038/bmt.2012.214

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