Risk of myelodysplastic syndrome and acute myeloid leukemia following autologous transplantation for lymphoma according to type and intensity of pretransplantation chemotherapy, without adjustment for transplantation-related factors
| Risk factors . | Cases/controls . | RR . | 95% CI . | P . |
|---|---|---|---|---|
| Model 1:* type of pretransplantation chemotherapy | ||||
| Cyclophosphamide, no other AA | 9/59 | 1.0 | — | — |
| MOPP regimen ± other AA | 20/55 | 4.8 | 1.27-18.54 | .02 |
| Chlorambucil, no MOPP regimen ± other AA | 9/7 | 10.8 | 3.06-42.52 | .0002 |
| Other AA, no MOPP regimen, no chlorambucil | 18/47 | 2.8 | 1.20-7.32 | .02 |
| Model 2:† cumulative dose of mechlorethamine (MOPP regimen) | ||||
| Less than 50 mg/m2 | 8/31 | 3.1 | 0.76-12.81 | .11 |
| 50 mg/m2 or higher | 12/24 | 6.6 | 1.57-29.37 | .01 |
| Ptrend .01 | ||||
| Model 3:‡ duration of chlorambucil therapy | ||||
| Less than 10 months | 4/5 | 7.1 | 1.38-38.86 | .02 |
| 10 months or longer | 5/2 | 16.5 | 3.06-130.32 | .001 |
| Ptrend.0002 |
| Risk factors . | Cases/controls . | RR . | 95% CI . | P . |
|---|---|---|---|---|
| Model 1:* type of pretransplantation chemotherapy | ||||
| Cyclophosphamide, no other AA | 9/59 | 1.0 | — | — |
| MOPP regimen ± other AA | 20/55 | 4.8 | 1.27-18.54 | .02 |
| Chlorambucil, no MOPP regimen ± other AA | 9/7 | 10.8 | 3.06-42.52 | .0002 |
| Other AA, no MOPP regimen, no chlorambucil | 18/47 | 2.8 | 1.20-7.32 | .02 |
| Model 2:† cumulative dose of mechlorethamine (MOPP regimen) | ||||
| Less than 50 mg/m2 | 8/31 | 3.1 | 0.76-12.81 | .11 |
| 50 mg/m2 or higher | 12/24 | 6.6 | 1.57-29.37 | .01 |
| Ptrend .01 | ||||
| Model 3:‡ duration of chlorambucil therapy | ||||
| Less than 10 months | 4/5 | 7.1 | 1.38-38.86 | .02 |
| 10 months or longer | 5/2 | 16.5 | 3.06-130.32 | .001 |
| Ptrend.0002 |
RR indicates relative risk; CI, confidence interval; AA, alkylating agents; MOPP, mechlorethamine, vincristine, procarbazine, prednisone; and —, reference group.
RRs are adjusted for pretransplantation radiotherapy (1 variable); subjects in cyclophosphamide group (eg, CHOP, CVP, MACOP-B) did not receive other alkylating agents (except ifosfamide given in 1 case and 8 controls). Subjects in MOPP group may have received other alkylating agents; subjects in chlorambucil group may have received other alkylating agents, except MOPP regimen.
Reference group consists of patients treated with cyclophosphamide-based regimen only (refer to Model 1). RRs are adjusted for duration of chlorambucil (2 variables) and therapy with other alkylating agents (1 variable).
Reference group consists of patients treated with cyclophosphamide-based regimen only (refer to Model 1). RRs are adjusted for cumulative dose of mechlorethamine (2 variables) and therapy with other alkylating agents (1 variable).