title: Allogeneic stem cell transplantation for chronic myelomonocytic leukemia: a report from the Societe Francaise de Greffe de Moelle et de Therapie Cellulaire.
abstract: OBJECTIVE
  Chronic myelomonocytic leukemia (CMML) is a severe disease for which allogeneic stem cell transplantation (allo-SCT) remains the only potentially curative treatment. We describe a retrospective study determining prognostic factors for outcome after allo-SCT in consecutive 73 patients with CMML reported to the SFGM-TC registry between 1992 and 2009.
  
  
  RESULTS
  At diagnosis, median age was 53 yrs, and 36% patients had palpable splenomegaly (SPM). 48, 13, and 9 patients had good, intermediate, and poor risk karyotype, respectively, according to IPSS, 61% patients had CMML-1, and 39% had CMML-2. 41/31/1 cases had an HLA-identical sibling, an unrelated and haploidentical donor, respectively. 43 patients received reduced-intensity conditioning. With a median follow-up of 23 month, acute grade 2-4 and chronic GVHD developed in 21 and 25 patients, respectively. The 3-year OS, NRM (non-relapse mortality),EFS, and CIR (cumulative incidence of relapse) were 32%, 36%, 29% and 35%, respectively. OS was not influenced by the CR status, marrow blasts% at allo-SCT, prior treatments, and cGVHD. Using multivariate analysis, year of transplant < 2004 (YOT) (P = 0.005) was associated with higher NRM, YOT <2004 (P = 0.04) and SPM at allo-SCT (P = 0.02) with lower EFS, and YOT < 2004 (P = 0.03) and SPM at allo-SCT (P = 0.04) with poorer OS.
  
  
  CONCLUSIONS
  Allogeneic stem cell transplantation is a valid treatment option for patients with CMML, and its outcome has improved with YOT > 2004. Splenomegaly seems to be a negative factor of OS and EFS in this series.
authors: Hematology, Hôpital Cochin, Université Paris V, Paris, France. sophie.park@cch.aphp.fr
authors: Sophie
authors: S
authors: Park
authors: Myriam
authors: M
authors: Labopin
authors: Ibrahim
authors: I
authors: Yakoub-Agha
authors: Jacques
authors: J
authors: Delaunay
authors: Nathalie
authors: N
authors: Dhedin
authors: Eric
authors: E
authors: Deconinck
authors: Mauricette
authors: M
authors: Michallet
authors: Marie
authors: M
authors: Robin
authors: Thierry
authors: T
authors: De Revel
authors: Marc
authors: M
authors: Bernard
authors: Norbert
authors: N
authors: Vey
authors: Bruno
authors: B
authors: Lioure
authors: Simona
authors: S
authors: Lapusan
authors: Reza
authors: R
authors: Tabrizi
authors: Jean-Henri
authors: JH
authors: Bourhis
authors: Anne
authors: A
authors: Huynh
authors: Yves
authors: Y
authors: Beguin
authors: Gérard
authors: G
authors: Socié
authors: François
authors: F
authors: Dreyfus
authors: Pierre
authors: P
authors: Fenaux
authors: Mohamad
authors: M
authors: Mohty
mesh_terms: D000368:Aged; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005602:France; D006086:Graft vs Host Disease / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D015994:Incidence; D015477:Leukemia, Myelomonocytic, Chronic / Q000453:epidemiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012008:Recurrence; D012042:Registries; D012189:Retrospective Studies; D016019:Survival Analysis; D014184:Transplantation, Homologous; D016896:Treatment Outcome