Characteristics of patients who underwent allogeneic HCT for a therapy-related MDS and AML reported to the CIBMTR between 1990 and 2004
| Characteristics of patients . | No. evaluable* . | No. (%) . |
|---|---|---|
| No. of patients | 868 | |
| No. of centers† | 211 | |
| Median age, y (range)† | 868 | 40 (4-72) |
| Karnofsky/Lansky score prior to HCT < 90%† | 824 | 294 (36) |
| Disease† | 868 | |
| t-AML | 545 (63) | |
| t-MDS | 323 (37) | |
| Prior disease† | 868 | |
| Hodgkin lymphoma | 199 (23) | |
| Non-Hodgkin lymphoma | 183 (21) | |
| Breast cancer | 139 (16) | |
| Acute lymphoblastic leukemia | 101 (12) | |
| Chronic lymphocytic leukemia | 9 (1) | |
| Plasma cell disorder | 12 (1) | |
| Sarcoma/Ewing | 72 (8) | |
| Wilms tumor/neuroblastoma | 10 (1) | |
| Testis/ovarian/germ cell | 50 (6) | |
| CNS | 15 (2) | |
| Autoimmune‡ | 38 (4) | |
| Other solid tumors§ | 33 (4) | |
| Rheumatoid arthritis | 4 (1) | |
| Others‖ | 3 (<1) | |
| Time from diagnosis of prior disease to t-MDS/t-AML, y† | 868 | 4 (< 1-28) |
| Prior therapy† | 868 | |
| Radiation + chemotherapy | 444 (51) | |
| Radiation (not chemotherapy) | 39 (4) | |
| Chemotherapy (not radiation) or others | 385 (45) | |
| Prior autologous transplantation†¶ | 868 | 151 (17) |
| Prior t-MDS (for t-AML)† | 539 | 163 (30) |
| Time from prior t-MDS to t-AML, mo | 144 | 3 (< 1-98) |
| WBC count at diagnosis, ×109/L | 757 | 4 (< 1-827) |
| Cytogenetics† | 727 | |
| AML | 727 | |
| Good/favorable prognosis | 32 (4) | |
| Intermediate prognosis | 314 (43) | |
| Poor/unfavorable prognosis | 102 (14) | |
| MDS | ||
| Good/favorable prognosis | 35 (5) | |
| Intermediate prognosis | 123 (17) | |
| Poor/unfavorable prognosis | 121 (17) | |
| Duration of CR1, for t-AML patients in CR2 or beyond or in relapse at time of HCT† | 103 | |
| 12 mo or less | 83 (81) | |
| More than 12 mo | 20 (19) | |
| Disease status prior to HCT† | 868 | |
| t-AML | ||
| CR1 | 279 (32) | |
| CR2 or beyond | 38 (4) | |
| Relapse | 80 (9) | |
| Primary induction failure | 148 (17) | |
| t-MDS | ||
| Early | 111 (13) | |
| Advanced | 212 (25) | |
| Conditioning regimen† | 868 | |
| Myeloablative | 670 (77) | |
| Reduced intensity/nonmyeloablative | 198 (23) | |
| Type of donor†# | 868 | |
| HLA-identical sibling | 282 (33) | |
| Other relative, partial or mismatched | 47 (5) | |
| URD, well matched | 204 (24) | |
| URD, partially matched | 227 (26) | |
| URD, mismatched | 108 (12) | |
| Graft type† | 868 | |
| Bone marrow | 571 (66) | |
| PBSC | 297 (34) | |
| GVHD prophylaxis† | 868 | |
| Cyclosporine or tacrolimus + MTX ± other | 674 (78) | |
| Tacrolimus or cyclosporine ± other (not MTX) | 62 (7) | |
| T-cell depletion | 107 (12) | |
| Other | 25 (3) | |
| Donor lymphocyte infusions (after HCT) | 866 | 42 (5) |
| Median FU of survivors, mo (range) | 61 (3-187) |
| Characteristics of patients . | No. evaluable* . | No. (%) . |
|---|---|---|
| No. of patients | 868 | |
| No. of centers† | 211 | |
| Median age, y (range)† | 868 | 40 (4-72) |
| Karnofsky/Lansky score prior to HCT < 90%† | 824 | 294 (36) |
| Disease† | 868 | |
| t-AML | 545 (63) | |
| t-MDS | 323 (37) | |
| Prior disease† | 868 | |
| Hodgkin lymphoma | 199 (23) | |
| Non-Hodgkin lymphoma | 183 (21) | |
| Breast cancer | 139 (16) | |
| Acute lymphoblastic leukemia | 101 (12) | |
| Chronic lymphocytic leukemia | 9 (1) | |
| Plasma cell disorder | 12 (1) | |
| Sarcoma/Ewing | 72 (8) | |
| Wilms tumor/neuroblastoma | 10 (1) | |
| Testis/ovarian/germ cell | 50 (6) | |
| CNS | 15 (2) | |
| Autoimmune‡ | 38 (4) | |
| Other solid tumors§ | 33 (4) | |
| Rheumatoid arthritis | 4 (1) | |
| Others‖ | 3 (<1) | |
| Time from diagnosis of prior disease to t-MDS/t-AML, y† | 868 | 4 (< 1-28) |
| Prior therapy† | 868 | |
| Radiation + chemotherapy | 444 (51) | |
| Radiation (not chemotherapy) | 39 (4) | |
| Chemotherapy (not radiation) or others | 385 (45) | |
| Prior autologous transplantation†¶ | 868 | 151 (17) |
| Prior t-MDS (for t-AML)† | 539 | 163 (30) |
| Time from prior t-MDS to t-AML, mo | 144 | 3 (< 1-98) |
| WBC count at diagnosis, ×109/L | 757 | 4 (< 1-827) |
| Cytogenetics† | 727 | |
| AML | 727 | |
| Good/favorable prognosis | 32 (4) | |
| Intermediate prognosis | 314 (43) | |
| Poor/unfavorable prognosis | 102 (14) | |
| MDS | ||
| Good/favorable prognosis | 35 (5) | |
| Intermediate prognosis | 123 (17) | |
| Poor/unfavorable prognosis | 121 (17) | |
| Duration of CR1, for t-AML patients in CR2 or beyond or in relapse at time of HCT† | 103 | |
| 12 mo or less | 83 (81) | |
| More than 12 mo | 20 (19) | |
| Disease status prior to HCT† | 868 | |
| t-AML | ||
| CR1 | 279 (32) | |
| CR2 or beyond | 38 (4) | |
| Relapse | 80 (9) | |
| Primary induction failure | 148 (17) | |
| t-MDS | ||
| Early | 111 (13) | |
| Advanced | 212 (25) | |
| Conditioning regimen† | 868 | |
| Myeloablative | 670 (77) | |
| Reduced intensity/nonmyeloablative | 198 (23) | |
| Type of donor†# | 868 | |
| HLA-identical sibling | 282 (33) | |
| Other relative, partial or mismatched | 47 (5) | |
| URD, well matched | 204 (24) | |
| URD, partially matched | 227 (26) | |
| URD, mismatched | 108 (12) | |
| Graft type† | 868 | |
| Bone marrow | 571 (66) | |
| PBSC | 297 (34) | |
| GVHD prophylaxis† | 868 | |
| Cyclosporine or tacrolimus + MTX ± other | 674 (78) | |
| Tacrolimus or cyclosporine ± other (not MTX) | 62 (7) | |
| T-cell depletion | 107 (12) | |
| Other | 25 (3) | |
| Donor lymphocyte infusions (after HCT) | 866 | 42 (5) |
| Median FU of survivors, mo (range) | 61 (3-187) |
HCT indicates hematopoietic cell transplantation; MDS, myelodysplastic syndrome; AML, acute myeloid leukemia; CIBMTR, Center for International Bone Marrow Transplantation Research; t-AML, therapy-related AML; t-MDS, therapy-related MDS; CNS, central nervous system; WBC, white blood cell; CR1, first complete remission; CR2, second complete remission; HLA, human leukocyte antigen; URD, unrelated donor; PBSC, peripheral blood stem cell; GVHD, graft-versus-host disease; MTX, methotrexate; and FU, follow-up.
Number of patients with available information.
Variables considered for inclusion within the multivariate analysis.
Autoimmune includes sarcoidosis (n = 1); Bechet syndrome (n = 5); Wegener granulomatosis (n = 12); polymyositis (n = 1); lupus (n = 6); Crohn disease (n = 4); polyarteritis nodosa (n = 2); psoriasis (n = 1); unspecified (n = 6). The prior therapies received were chemotherapy ± other (n = 30); radiation ± other (n = 1); and other therapy (n = 7).
Other solid tumors includes adenocarcinoma (n = 4); thyroid cancer (n = 3); colon cancer (n = 3); cervical/endometrial cancer (n = 4); squamous cell cancer (n = 3); hepatocellular cancer (n = 1); brain tumor (n = 7); and unspecified (n = 1).
The other prior diseases were hyperthyroidism (n = 1); kidney or cardiac transplantation (n = 2); and posttransplantation lymphoproliferative disorder (n = 1).
See Table 2.
Donor-recipient classification based on Weisdorf et al.22