Allogeneic bone marrow transplantation for secondary leukaemia and myelodysplastic syndrome: a survey by the Leukaemia Working Party of the European Bone Marrow Transplantation Group (EBMTG)

Dewitte, T.; Ferrant, Augustin; Zwaan, F. E.; Hermans, J.; Vernant, Jean‐Paul; Kolb, Hans‐Jochem; Vossen, J. M. J. J.; Lönnqvist, B; Beelen, Dietrich W.; Gmür, J; Yin, J. A. Liu; Troussard, Xavier; Cahn, Jean‐Yves; VanLint, M T; Gratwohl, Aloïs

doi:10.1111/j.1365-2141.1990.tb02558.x

Cited by 168 publications

(83 citation statements)

References 20 publications

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“…23,24 Prolonged disease-free survival can be expected in only about 20% of patients transplanted for sAML. 25 Anderson et al 26 also reported that the 5-year survival of secondary AML patients was 24.4% after stem cell transplantation. The number of patients who benefit from allogeneic BMT is larger for AML-TLD than sAML because of the better CR rate and the lower ages of the patients.…”

Section: Discussionmentioning

confidence: 96%

Allogeneic bone marrow transplantation improves the outcome of de novo AML with trilineage dysplasia (AML-TLD)

et al. 2000

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De novo acute myeloid leukemia (AML) with dysplastic features in erythroblasts, granulocytes and megakaryocytes, similar to those in myelodysplastic syndrome (MDS) has been described as AML with trilineage dysplasia (AML-TLD) since 1987. Several reports have suggested that AML-TLD is a subtype of de novo AML in adults and has a poor clinical outcome when treated by conventional chemotherapy. It is not certain whether allogeneic bone marrow transplantation (BMT) brings a favorable outcome for AML-TLD. To evaluate the therapeutic efficacy of allogeneic BMT for AML-TLD, we investigated the clinical data and outcomes of conventional chemotherapy and allogeneic BMT for 118 patients with de novo AML. These patients were registered consecutively for the Japan Adult Leukemia Study Group (JALSG) protocols at our institutes. We treated 28 AML-TLD patients and 90 AML-nonTLD patients with conventional chemotherapeutic protocols. AML-TLD patients did not have a significantly different complete remission (CR) rate (75.0% and 88.4% P = 0.1234), but had a significantly higher relapse rate than AML-nonTLD patients (94.1% and 49.3%, P = 0.0007). The outcome of chemotherapy for AML-TLD was significantly worse than that for AML-nonTLD. The overall survival (OS) and leukemia-free survival (LFS) at 6 years were 9.4% and 0% in AML-TLD group, and 51.9% (P = 0.0017) and 46.3% (P Ͻ 0.0001) in AML-nonTLD group, respectively. Meanwhile, among the patients who underwent allogeneic BMT, five of eight AML-TLD patients and eight of 14 AML-nonTLD patients were alive, and three and five patients survived more than 3 years, respectively. These results suggest that allogeneic BMT can improve the outcome for AML-TLD, which is poor when conventional chemotherapy is given alone. Allogeneic BMT before relapse may be the best therapeutic strategy for AML-TLD patients under 50 years of age if a donor is available.

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Section: Discussionmentioning

confidence: 96%

Allogeneic bone marrow transplantation improves the outcome of de novo AML with trilineage dysplasia (AML-TLD)

et al. 2000

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“…19,21,44 Others have shown fewer relapses among patients with longer disease duration before transplant. 24 In the present series, patients with RAEB-T had a statistically significant higher relapse rate compared to patients with RA/RARS.…”

Section: Discussionmentioning

confidence: 99%

Allogeneic bone marrow transplantation in children with myelodysplastic syndrome or juvenile myelomonocytic leukemia: the Seattle experience

Yusuf

Frangoul

Gooley

et al. 2004

Bone Marrow Transplant

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Summary:The purpose of this study was to evaluate the role of allogeneic bone marrow transplantation (BMT) in children with myelodysplastic syndrome (MDS). In total, 94 consecutive pediatric patients with MDS received an allogeneic BMT from 1976 to 2001 for refractory anemia (RA) (n ¼ 25), RA with ringed sideroblasts (RARS) (n ¼ 2), RA with excess blasts (RAEB) (n ¼ 20), RAEB in transformation (RAEB-T) (n ¼ 14), juvenile myelomonocytic leukemia (JMML) (n ¼ 32) or chronic myelomonocytic leukemia (CMML) (n ¼ 1). The estimated 3-year probabilities of survival, event-free survival (EFS), nonrelapse mortality and relapse were 50, 41, 28 and 29%, respectively. Patients with RA/RARS had an estimated 3-year survival of 74% compared to 68% in those with RAEB and 33% in patients with JMML/CMML. In multivariable analysis, patients with RAEB-T or JMML were 3.9 and 3.7 times more likely to die compared to those with RA/RARS and RAEB (P ¼ 0.005 and 0.004, respectively). Patients with RAEB-T were 5.5 times more likely to relapse (P ¼ 0.01). The median follow-up among the 43 surviving patients is 10 years (range 1-25). We conclude that allogeneic BMT for children with MDS is well tolerated and can be curative.

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“…7,8 The Chronic Leukemia Working Party of the EBMT has collected data on several hundreds of patients transplanted for myelodysplasia and the first analysis was reported in 1990. 5 Two-thirds of the patients with MDS who may benefit from allogeneic BMT lack a suitable family donor. Increasing size of the donor registries has made allogeneic BMT with an unrelated donor a realistic alternative.…”

Section: Discussionmentioning

confidence: 99%

“…Actuarial diseasefree survival (DFS) ranges between 35 and 45% at 2 to 4 years after BMT. [4][5][6][7][8] About 30% of younger patients with MDS/sAML will have an HLA-identical sibling donor and about 5% a one HLA locus mismatched family donor. Increasing size of the voluntary unrelated donor registries facilitates the identification of matched unrelated donors for about 75% of patients.…”

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confidence: 99%

Unrelated bone marrow transplantation in patients with myelodysplastic syndromes and secondary acute myeloid leukemia: an EBMT survey

Arnold

Witte

Biezen

et al. 1998

Bone Marrow Transplant

107

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Summary:The Chronic Leukemia Working Party of the EBMT has collected data on 118 patients of median age 24 years (range 0.3 to 53 years) who underwent an allogeneic bone marrow transplantation from unrelated donors for treatment of MDS or secondary AML (RA/RARS, n = 24; RAEB, n = 26; RAEB-t, n = 34; CMML, n = 12; sAML, n = 22) between 1986 and 1996. The data were reported by 49 EBMT centers. Thirtyfour of 118 patients are alive, relapse was the cause of death in 19 of 84 patients and the remaining patients died of transplant-related mortality. For the whole group the actuarial probability of survival at 2 years is 28%, disease-free survival 28%, relapse risk 35% and transplant-related mortality is 58%. The transplantrelated mortality is significantly influenced by the age of the recipient (Ͻ18 years 40%, 18-35 years 61%, Ͼ35 years 81%). The relapse rate after BMT is influenced by FAB classification of the disease at BMT. Patients with a low blast count (RA, RAEB) have a lower probability of relapse (13%, 15%) compared to patients with RAEB-t or sAML (29%, 45%). Furthermore, we found evidence of a graft-versus-leukemia effect in MDS/sAML. Patients with acute GVHD, grade II-IV, had a probability of relapse of 26% vs 42% in patients with no acute GVHD or grade I only. Allogeneic transplantation with an HLA-matched, unrelated donor may be offered to younger patients (age Ͻ35 years) with poor risk myelodysplasia or secondary AML. Keywords: unrelated BMT; MDS; sAML Myelodysplastic syndromes (MDS) are acquired clonal disorders of the hematopoietic stem cell characterized by ineffective hematopoiesis and progressive peripheral cytopenias. Infections due to neutropenia and thrombocytopenic bleeding are the most frequent causes of death. Ten to 40%

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Allogeneic bone marrow transplantation for secondary leukaemia and myelodysplastic syndrome: a survey by the Leukaemia Working Party of the European Bone Marrow Transplantation Group (EBMTG)

Cited by 168 publications

References 20 publications

Allogeneic bone marrow transplantation improves the outcome of de novo AML with trilineage dysplasia (AML-TLD)

Allogeneic bone marrow transplantation improves the outcome of de novo AML with trilineage dysplasia (AML-TLD)

Allogeneic bone marrow transplantation in children with myelodysplastic syndrome or juvenile myelomonocytic leukemia: the Seattle experience

Unrelated bone marrow transplantation in patients with myelodysplastic syndromes and secondary acute myeloid leukemia: an EBMT survey

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