title: Reduced-intensity allografting in patients with therapy-related myeloid neoplasms and active primary malignancies.
abstract: Therapy-related myeloid neoplasms (t-MNs) are severe long-term consequences of cytotoxic treatments for a primary, often, malignant disorder. So far, the majority of patients eligible for transplantation have undergone myeloablative allo haematopoietic SCT (HSCT) as a potentially curative treatment, but it has been associated with high transplantation-related mortality (TRM) rates. In this retrospective study, we analysed the outcome of patients with t-MNs undergoing HSCT with reduced-intensity conditioning (RIC). Of 55 patients, seen at a single centre over a 10-year period, 17 underwent RIC HSCT with related or unrelated donors. The estimated overall survival was 53% at 1 year and 47% at 3 years, and disease-free survival was 47% at 1 year. At 1 year, the cumulative incidence of relapse and TRM were 24% and 30%, respectively. Of five patients with active primary neoplasms who underwent transplantation, two are alive beyond 1 year and show CR of both t-MNs and the primary malignancy. These data indicate that RIC HSCT is an encouraging approach for patients with t-MNs. The issue of primary malignancies not being in remission at the time of transplantation should be explored in further studies.
authors.affiliation: Division of Haematology, Medical University of Graz, Graz, Austria.
authors.forename: W
authors.initials: W
authors.lastname: Zinke-Cerwenka
authors.forename: A
authors.initials: A
authors.lastname: Valentin
authors.forename: U
authors.initials: U
authors.lastname: Posch
authors.forename: C
authors.initials: C
authors.lastname: Beham-Schmid
authors.forename: A
authors.initials: A
authors.lastname: Groselj-Strele
authors.forename: W
authors.initials: W
authors.lastname: Linkesch
authors.forename: A
authors.initials: A
authors.lastname: Wölfler
authors.forename: H
authors.initials: H
authors.lastname: Sill
mesh_terms: D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D019337:Hematologic Neoplasms / Q000401:mortality* / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous