Abstract
The incidence of secondary myelodysplastic syndromes and acute leukemia (MDS/AL) was reported for 395 patients autografted for Hodgkin's disease (HD) (n = 96) and non-Hodgkin's lymphoma (NHL) (n = 299) between 1987 and 1998. Eleven patients developed secondary MDS/AL (crude rate at 2.8%) including two lymphoblastic AL cases. The mean time of occurrence was at 32 months after autologous stem cell transplantation (ASCT) and 71 months after diagnosis. The estimated actuarial incidence at 10 years was at 6.3% (±4%). Karyotyping revealed complex chromosomal aberrations in only one patient, and two translocations [t(8;21) and t(8;16)]. No features of topoisomerase II inhibitor-related leukemia were found. Only one patient had received ASCT in first remission. The remaining 10 patients had received multiple courses of chemotherapy before stem cell collection and four had relapsed after ASCT and before the occurrence of secondary MDS/AL. Five of 11 patients had received localized radiotherapy and five others received TBI in their conditioning regimen. Ten patients died despite chemotherapy and/or supportive care and only one patient is alive and well after genoidentical allogeneic transplantation. We suggest a cumulative leukemogenic role of pre-ASCT radiation and chemotherapy in the occurrence of these secondary MDS/AL more than the high-dose therapy itself. Bone Marrow Transplantation (2000) 26, 321–326.
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References
Linch DC, Winfield D, Hudson Vaughan G et al. Dose intensification with autologous bone-marrow transplantation in relapsed and resistant Hodgkin's disease: results of a BNLI randomised trial Lancet 1993 341: 1051–1054
Philip T, Guglielmi C, Hagenbeek A et al. Autologous bone marrow transplantation as compared with salvage chemotherapy in relapses of chemotherapy-sensitive non Hodgkin lymphoma New Engl J Med 1995 333: 1540–1545
Levine EG, Bloomfield CD . Leukemias and myelodysplastic syndromes secondary to drug, radiation, and environmental exposure Semin Oncol 1992 19: 47–84
Stone RM . Myelodysplastic syndrome as a late complication following autologous bone marrow transplantation for non-Hodgkin's lymphoma J Clin Oncol 1994 12: 2535–2542
Pedersen-Bjergaard J, Specht L, Larsen SO et al. Risk of therapy-related leukemia and preleukemia after Hodgkin's disease. Relation to age, cumulative dose of alkylating agents, and time from chemotherapy Lancet 1987 2: 83–88
The international non-Hodgkin's lymphoma prognostic factors project: a predictive model for aggressive lymphoma New Engl J Med 1993 329: 987–984
Brice P, Marolleau JP, Pautier P, Gisselbrecht C . Hematologic recovery and survival of lymphoma patients after autologous stem-cell transplantation: comparison of bone marrow and peripheral blood progenitor cells Leuk Lymphoma 1996 22: 449–456
Kaplan ES, Meier P . Non parametric estimation from incomplete observations J Am Stat Assoc 1958 53: 457–461
Scheinkein DP, Schwartz RS . Neoplasms and transplantation – trading swords for plowshares New Engl J Med 1997 336: 949–950
Lowsky R, Lipton J, Messner H . Secondary malignancies after bone marrow transplantation in adults J Clin Oncol 1994 12: 2187–2192
André M, Henry-Amar M, Blaise D et al. Treatment related deaths and second cancer risk after autologous stem cell transplantation for Hodgkin's disease Blood 1998 92: 1933–1940
Miller JS, Arthur DC, Litz CE et al. Myelodysplastic syndrome after autologous bone marrow transplantation: an additional late complication of curative cancer therapy Blood 1994 83: 3780–3786
Andrieu JM, Ifrah N, Payen C et al. Increase of secondary acute nonlymphocytic leukemia after extended field radiation therapy combined with MOPP chemotherapy for Hodgkin's disease J Clin Oncol 1990 8: 1148–1154
Mendenhall NP, Noyes WD, Million RR . Total body irradiation for stage II–IV non-Hodgkin's lymphoma: ten-year follow-up J Clin Oncol 1989 7: 67–74
Moloney WC . Radiogenic leukemia revisited Blood 1987 70: 905–908
Carbonell F, Ganser A, Fliedner TM et al. The fate of cells with chromosome aberrations after total-body irradiation and bone marrow transplantation Radiat Res 1983 93: 453–460
Sandoval C, Pui CH, Bowman LC . Secondary acute myeloid leukemia in children previously treated with alkylating agents, intercalating topoisomerase II inhibitors, and irradiation J Clin Oncol 1993 11: 1039–1045
Travis LB, Weeks J, Curtis RE et al. Leukemia following low-dose total body irradiation and chemotherapy for non-Hodgkin's lymphoma J Clin Oncol 1996 14: 565–571
Friedberg JW, Neuberg D, Stone RM et al. Outcome in patients with myelodysplastic syndrome after autologous bone-marrow transplantation in non Hodgkin's lymphoma J Clin Oncol 1999 17: 3128–3135
Chasen MR, Falkson G . Leukemia after chemotherapy for cancer Cancer Biother 1993 8: 115–122
Tura S, Fiacchini M, Gobbi PG . Splenectomy and the increasing risk of secondary acute leukemia in Hodgkin's disease J Clin Oncol 1993 11: 925–930
Hawkins MM . Secondary leukemia after epidophyllotoxins Lancet 1991 38: 1408
Krishnan A, Bhatia S, Forman SJ . Risk factors for development of therapy-related leukemia (t-MDS/t-AML) following autologous transplantation (ABMT) for lymphoma Abstracts of the ASH 40th Annual Meeting, Dec 4–8 1998
Schlaifer D, Riga-Huguet F, Bosly A . Secondary neoplasms in two patients treated with purine analogues Nouv Rev Fr Hematol 1994 36: 341
Symann M, Bosly A, Gisselbrecht C . Immune reconstitution after bone-marrow transplantation Cancer Treat Rev 1989 16: (Suppl.) 15–19
Meyerson HJ, Farhi DC, Rosenthal NS . Transient increase in blasts mimicking acute leukemia and progressing myelodysplasia in patients receiving growth factor Am J Clin Pathol 1998 109: 605–681
Darrington DL, Vose JM, Anderson JR et al. Incidence and characteristics of secondary myelodysplastic syndrome and acute myelogenous leukemia following high-dose chemotherapy and ASCT for lymphoid malignancies J Clin Oncol 1994 12: 2527–2532
Deeg HJ, Socié G . Malignancies after hematopoietic stem cell transplantation: many questions, some answers Blood 1998 91: 1833–1844
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We thank Dr Nicolas Mounier for his assistance with the statistics concerning the actuarial incidence.
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Park, S., Brice, P., Noguerra, M. et al. Myelodysplasias and leukemias after autologous stem cell transplantation for lymphoid malignancies. Bone Marrow Transplant 26, 321–326 (2000). https://doi.org/10.1038/sj.bmt.1702510
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DOI: https://doi.org/10.1038/sj.bmt.1702510
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