Medline: 7989926

The abstract Journal of Clinical Oncology 12(12): 2527-2534, 1994. is available online.

The fulltext Journal of Clinical Oncology 12(12): 2527-2534, 1994. may be available online for subscribers.

Incidence and characterization of secondary myelodysplastic syndrome and acute myelogenous leukemia following high-dose chemotherapy and autologous stem-cell transplantation for lymphoid malignancies.

Darrington DL, Vose JM, Anderson JR, et al.

Abstract:

Purpose:
To analyze the risk of developing myelodysplastic syndrome (MDS) or acute myelogenous leukemia (AML) following autologous bone marrow transplantation (ABMT) or peripheral stem-cell transplantation (PSCT) and to determine the impact on failure-free survival (FFS).

Patients and Methods:
Patients underwent ABMT or PSCT for the treatment of Hodgkin's disease (HD) and non-Hodgkin's lymphoma (NHL) at the University of Nebraska Medical Center. For those patients who went on to develop MDS/AML, controls were selected and a case-control-within-a-cohort study undertaken.

Results:
Twelve patients developed MDS or AML a median of 44 months following ABMT/PSCT. The cumulative incidence (P = .42) and the conditional probability (P = .32) of MDS/AML were not statistically different between HD and NHL patients. Age greater than 40 years at the time of transplant (P = .05) and receipt of a total-body irradiation (TBI)-containing regimen (P = .06) were predictive for developing MDS/AML in patients with NHL.

Conclusion:
There is an increased risk of MDS/AML following ABMT/PSCT for lymphoid malignancies. NHL patients age > or = 40 years at the time of transplant and who received TBI are at greatest risk.


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