title: Hematopoietic stem cell transplantation for therapy-related myelodysplastic syndrome and acute leukemia: a single-center analysis of 47 patients.
abstract: The prognosis of therapy-related myelodysplastic syndrome and acute leukemia (t-MDS/AL) remains poor. We retrospectively analyzed the data of 47 patients (31 AL and 16 MDS) who were treated at our institute. Thirty-three patients received disease-adapted chemotherapy, with a response rate of 73%, while 14 received no interventions due to an indolent course, such as MDS. The median follow-up of surviving patients was 1.9 years (range 0.1-10.5) after the diagnosis of t-MDS/AL, and the estimated 3-year overall survival (OS) for all patients was 55%. Twenty-seven patients underwent allogeneic hematopoietic stem cell transplantation (HCT), and the 3-year non-relapse mortality was 17%. Twenty patients did not undergo HCT due to various reasons including advanced age or comorbidities. The 3-year OS was better in patients who received HCT than in those who did not (71 vs. 31%; p = 0.018). A multivariate analysis revealed that HCT was associated with a better OS. Although this study has several limitations, including a potential selection bias due to the retrospective nature of the analysis and a small number of patients, the results show that modern HCT may be useful for inducing long-term survival in a fraction of patients suffering from t-MDS/AL. The present findings warrant future prospective studies.
authors.affiliation: Hematopoietic Stem Cell Transplantation Division, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Yokoyama
authors.forename: Shin-ichiro
authors.initials: S
authors.lastname: Mori
authors.forename: Yukio
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: Saiko
authors.initials: S
authors.lastname: Kurosawa
authors.forename: Bungo
authors.initials: B
authors.lastname: Saito
authors.forename: Shigeo
authors.initials: S
authors.lastname: Fuji
authors.forename: Dai
authors.initials: D
authors.lastname: Maruyama
authors.forename: Teruhisa
authors.initials: T
authors.lastname: Azuma
authors.forename: Sung-Won
authors.initials: SW
authors.lastname: Kim
authors.forename: Takashi
authors.initials: T
authors.lastname: Watanabe
authors.forename: Ryuji
authors.initials: R
authors.lastname: Tanosaki
authors.forename: Kensei
authors.initials: K
authors.lastname: Tobinai
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Takaue
authors.forename: Takahiro
authors.initials: T
authors.lastname: Fukuda
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods / Q000401:mortality*; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000209:etiology / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D016609:Neoplasms, Second Primary / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D012189:Retrospective Studies; D015996:Survival Rate; D055815:Young Adult