Blood Res.  2013 Sep;48(3):178-184. 10.5045/br.2013.48.3.178.

Allogeneic hematopoietic cell transplantation in adult patients with myelodysplastic/myeloproliferative neoplasms

Affiliations
  • 1Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Korea.
  • 2Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. jhlee3@amc.seoul.kr

Abstract

BACKGROUND
In adults, the 2 main types of myelodysplastic/myeloproliferative neoplasms (MDS/MPN) are chronic myelomonocytic leukemia (CMML) and atypical chronic myeloid leukemia (aCML). Both are associated with a poor prognosis. Allogeneic hematopoietic cell transplantation (HCT) is the only known curative treatment modality for these diseases, but data on outcomes following such treatment are limited. We analyzed the outcomes of patients with MDS/MPN after allogeneic HCT.
METHODS
This retrospective study included 10 patients with MDS/MPN who received allogeneic HCT at Asan Medical Center from 2002 to 2010. Of these 10 patients, 7 had CMML, 2 had aCML, and 1 had unclassifiable MDS/MPN. Five patients received a myeloablative conditioning (MAC) regimen (busulfan-cyclophosphamide), and 5 received reduced-intensity conditioning (RIC) regimen.
RESULTS
Neutrophil engraftment was achieved in all patients. After a median follow-up of 47.5 months among surviving patients, 4 had relapsed and 5 had died. There was only 1 treatment-related death. The 5-year rates of overall, relapse-free, and event-free survival were 42.2%, 51.9%, and 46.7%, respectively. Relapse was the leading cause of treatment failure, and all relapses were observed in patients who had received RIC and who did not develop chronic graft-versus-host disease.
CONCLUSION
Allogeneic HCT can induce durable remission in patients with MDS/MPN, but RIC cannot replace MAC in patients eligible for myeloablative treatments.

Keyword

MDS/MPN; Allogeneic HCT; Reduced-intensity; Relapse

MeSH Terms

Adult
Cell Transplantation
Disease-Free Survival
Follow-Up Studies
Humans
Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative
Leukemia, Myelomonocytic, Chronic
Neutrophils
Prognosis
Recurrence
Retrospective Studies
Transplants
Treatment Failure

Figure

  • Fig. 1 Survival differences between myeloablative conditioning and reduced-intensity conditioning; (A) overall survival, (B) relapse-free survival, (C) event-free survival.


Cited by  1 articles

Fighting back against chronic myelomonocytic leukemia
Deog-Yeon Jo
Blood Res. 2013;48(3):165-166.    doi: 10.5045/br.2013.48.3.165.


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