Allogeneic hematopoietic stem cell transplant in adult patients with myelodysplastic syndrome/myeloproliferative neoplasm (MDS/MPN) overlap syndromes.
MDS/MPN (myelodysplastic syndrome/myeloproliferative neoplasm) overlap syndromes are myeloid malignancies for which allogeneic hematopoietic stem cell transplant (allo-HSCT) is potentially curative. We describe transplant outcomes of 43 patients - 35 with chronic myelomonocytic leukemia, CMML (of which 17 had blast transformation, BT) and eight with MDS/MPN-unclassifiable (MDS/MPN,U). At median follow-up of 21 months, overall survival (OS), cumulative incidence of relapse (CIR) and non-relapse mortality (NRM) were 55%, 29%, and 25% respectively in CMML without BT and 47%, 40%, and 34% respectively in CMML with BT. Higher HSCT-comorbidity index (HSCT-CI >3 versus ≤3; p = 0.015) and splenomegaly (p = 0.006) predicted worse OS in CMML without BT. In CMML with BT, engraftment failure (p = 0.006) and higher HSCT-CI (p = 0.03) were associated with inferior OS, while HSCT within 1-year of diagnosis was associated with improved OS (p = 0.045). In MDS/MPN,U, at median follow-up of 15 months, OS, CIR, and NRM were 62%, 30%, and 14%, respectively.
a Division of Hematology, Department of Internal Medicine , Mayo Clinic College of Medicine , Rochester , MN.
Prashant
P
Sharma
a Division of Hematology, Department of Internal Medicine , Mayo Clinic College of Medicine , Rochester , MN.
Shivani S
SS
Shinde
a Division of Hematology, Department of Internal Medicine , Mayo Clinic College of Medicine , Rochester , MN.|b Division of Hematology, King Abdul Aziz Medical City , Riyadh , Saudi Arabia.
Moussab
M
Damlaj
a Division of Hematology, Department of Internal Medicine , Mayo Clinic College of Medicine , Rochester , MN.
Mehrdad
M
Hefazi Rorghabeh
a Division of Hematology, Department of Internal Medicine , Mayo Clinic College of Medicine , Rochester , MN.
Shahrukh K
SK
Hashmi
a Division of Hematology, Department of Internal Medicine , Mayo Clinic College of Medicine , Rochester , MN.
Mark R
MR
Litzow
a Division of Hematology, Department of Internal Medicine , Mayo Clinic College of Medicine , Rochester , MN.
William J
WJ
Hogan
a Division of Hematology, Department of Internal Medicine , Mayo Clinic College of Medicine , Rochester , MN.
Naseema
N
Gangat
a Division of Hematology, Department of Internal Medicine , Mayo Clinic College of Medicine , Rochester , MN.
Michelle A
MA
Elliott
a Division of Hematology, Department of Internal Medicine , Mayo Clinic College of Medicine , Rochester , MN.
Aref
A
Al-Kali
a Division of Hematology, Department of Internal Medicine , Mayo Clinic College of Medicine , Rochester , MN.
Ayalew
A
Tefferi
a Division of Hematology, Department of Internal Medicine , Mayo Clinic College of Medicine , Rochester , MN.
Mrinal M
MM
Patnaik
D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D009196:Myeloproliferative Disorders / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D010641:Phenotype; D011379:Prognosis; D012008:Recurrence; D016019:Survival Analysis; D013577:Syndrome; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous; D055815:Young Adult
D015415:Biomarkers
MDS/MPN overlap syndrome; MDS/MPN-unclassifiable; allogeneic hematopoietic stem cell transplant; chronic myelomonocytic leukemia (CMML)