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Allogeneic haematopoietic cell transplantation for therapy-related myeloid neoplasms arising following treatment for lymphoma: a retrospective study on behalf of the Chronic Malignancies Working Party of the EBMT

Bone Marrow Transplantation volume 59, pages 395–402 (2024)Cite this article

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Abstract

Therapy-related myeloid neoplasms (t-MN), either myelodysplastic neoplasms (t-MDS) or acute myeloid leukemias (t-AML), have a poor prognosis and allogeneic haematopoietic cell transplantation (allo-HCT) represents the only curative option. In this multicenter, registry-based study, we analyzed outcomes of 378 patients undergoing first allo-HCT between 2006–2017 for t-MN arising secondary to lymphoma treatment. Median age was 58 years at allo-HCT; 222 (59%) had a diagnosis of t-MDS and 156 (41%) of t-AML, respectively. At the time of allo-HCT, 46% of t-MN cases were reported as in complete remission (CR) and 15% of lymphomas were recorded as not in remission. A reduced intensity conditioning regimen was used in 70% of cases. For the entire cohort, 5-year OS, and t-MN PFS, relapse incidence and NRM were 32%, 28%, 35% and 37%, respectively. In multivariable analysis, undergoing allo-HCT with t-MN not in CR and older age were associated with significantly worse OS, PFS and NRM. At 5 years post allo-HCT, the relapse incidence of lymphoma was low at 3%, while the rate of secondary malignancies was 8%. This analysis shows the curative potential of allo-HCT for patients with t-MN arising secondary to lymphoma treatment in approximately a third of patients.

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Fig. 1: Transplant outcomes.
Fig. 2: Transplant outcomes: comparison between t-AML and t-MDS.

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Data availability

The datasets generated during and/or analysed during the current study are not routinely available due to data protection of patients enrolled in the EBMT database.

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Acknowledgements

The authors would like to thank all investigators and data managers in the EBMT participating centres for their excellent contribution. Funding: Funding for this study was indirectly provided by support of the CMWP of the EBMT.

Author information

Authors and Affiliations

  1. Hematology Service, Institut Central des Hôpitaux (ICH), Hôpital du Valais, Sion, Switzerland

    Mitja Nabergoj

  2. EBMT Statistical Unit, Leiden, The Netherlands

    Diderik-Jan Eikema

  3. EBMT Leiden Study Unit, Leiden, The Netherlands

    Linda Koster

  4. Medical Clinic and Policinic 1, Leipzig, Germany

    Uwe Platzbecker

  5. Department of Internal Medicine I, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany

    Katja Sockel

  6. University of Freiburg, Freiburg, Germany

    Jürgen Finke

  7. Department for Stem Cell Transplantation, University Medical Center Hamburg, Hamburg, Germany

    Nicolaus Kröger

  8. CHU Bordeaux, Pessac, France

    Edouard Forcade

  9. Chaim Sheba Medical Center, Tel-Hashomer, Israel

    Arnon Nagler

  10. Hannover Medical School, Hannover, Germany

    Matthias Eder

  11. Klinikum Grosshadern, Munich, Germany

    Johanna Tischer

  12. Erasmus MC Cancer Institute, Rotterdam, The Netherlands

    Annoek E. C. Broers

  13. University Medical Centre, Utrecht, The Netherlands

    Jürgen Kuball

  14. University Hospital of Wales, Cardiff, UK

    Keith M. O. Wilson

  15. CHRU, Angers, France

    Mathilde Hunault-Berger

  16. Adult HSCT unit, Newcastle, UK

    Matthew Collin

  17. Unit of Bone Marrow Transplantation, University of Brescia, ASST Spedali Civili, Brescia, Italy

    Domenico Russo

  18. Hematology Department, Hospital Universitario de Salamanca, IBSAL, CIBERONC Centro de Investigación del Cáncer-IBMCC (USAL-CSIC), Salamanca, Spain

    Lucía López Corral

  19. Silesian Medical Academy, Katowice, Poland

    Grzegorz Helbig

  20. Institut Català d’Oncologia-Hospital Duran i Reynals, Barcelona, Spain

    Alberto Mussetti

  21. University of Cologne, Cologne, Germany

    Christof Scheid

  22. Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133, Rome, Italy

    Carmelo Gurnari

  23. Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, 44195, USA

    Carmelo Gurnari

  24. Department of Haematology, University College London Hospitals NHS Trust, London, UK

    Kavita Raj & Donal P. McLornan

  25. University Clinical Centre, Medical University of Warsaw, Warsaw, Poland

    Joanna Drozd-Sokolowska

  26. CHU de Lille, Univ Lille, INSERM U1286, Infinite, 59000, Lille, France

    Ibrahim Yakoub-Agha

  27. Hopital Saint- Louis, APHP, Université de Paris Cité, Paris, France

    Marie Robin

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  1. Mitja Nabergoj
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Contributions

MN and MR designed the study. MN, MR interpreted the data. MN, MR and DM wrote the first draft of manuscript. DJE analyzed data and interpreted results. All authors contributed to the writing of the manuscript and approved the final version. Additional contributing centers are listed in Supplementary Table 5.

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Correspondence to Mitja Nabergoj.

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Nabergoj, M., Eikema, DJ., Koster, L. et al. Allogeneic haematopoietic cell transplantation for therapy-related myeloid neoplasms arising following treatment for lymphoma: a retrospective study on behalf of the Chronic Malignancies Working Party of the EBMT. Bone Marrow Transplant 59, 395–402 (2024). https://doi.org/10.1038/s41409-023-02193-z

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