title: Patient age and number of apheresis days may predict development of secondary myelodysplastic syndrome and acute myelogenous leukemia after high-dose chemotherapy and autologous stem cell transplantation for lymphoma.
abstract: The goal of our study was to find predictors for the development of secondary myelodysplastic syndrome or acute myelogenous leukemia (s-MDS/AML) in patients with relapsed or refractory lymphoma who received high-dose chemotherapy and autologous stem cell transplantation (ASCT).
  
  
  
  We conducted a retrospective review of 295 patients with relapsed or refractory lymphoma who had undergone their first stem cell collection and ASCT. Patient, disease, and treatment characteristics were collected. The primary goal of this study was to analyze the association between the number of apheresis days needed to collect the requisite stem cell dose in addition to the previously described factors such as age, sex, number and type of prior chemotherapeutic regimens, disease type and status, and the risk of developing s-MDS/AML.
  
  
  
  Twenty-two patients of 295 were diagnosed with s-MDS/AML after a median follow-up of 62 months. Multivariate analysis using a classification and regression tree showed that the incidence of s-MDS/AML was lowest in patients who were not more than 55 years old at transplantation and in whom the target cell dose was collected in fewer than two apheresis sessions (5-year cumulative incidence, 1%), whereas incidence was highest in patients who were more than 55 years old at transplantation and who received a transplant more than 21 months after their initial lymphoma diagnosis (5-year cumulative incidence, 20%).
  
  
  
  Our study defines a subset of relapsed or refractory lymphoma patients who should be closely monitored for development of s-MDS/AML after high-dose chemotherapy and ASCT.
authors.affiliation: Department of Gynecology and Obstetrics, University Medical Center, Freiburg, Germany.
authors.forename: Isabell
authors.initials: I
authors.lastname: Ge
authors.affiliation: Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Rima M
authors.initials: RM
authors.lastname: Saliba
authors.affiliation: Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Farzaneh
authors.initials: F
authors.lastname: Maadani
authors.affiliation: Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Uday R
authors.initials: UR
authors.lastname: Popat
authors.affiliation: Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Muzaffar H
authors.initials: MH
authors.lastname: Qazilbash
authors.affiliation: Department of Hematology and Oncology, Houston Methodist Cancer Center, Houston, Texas.
authors.forename: Sai
authors.initials: S
authors.lastname: Ravi Pingali
authors.affiliation: Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Nina
authors.initials: N
authors.lastname: Shah
authors.affiliation: Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Sairah
authors.initials: S
authors.lastname: Ahmed
authors.affiliation: Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Qaiser
authors.initials: Q
authors.lastname: Bashir
authors.affiliation: Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Yago
authors.initials: Y
authors.lastname: Nieto
authors.affiliation: Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Richard E
authors.initials: RE
authors.lastname: Champlin
authors.affiliation: Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Chitra
authors.initials: C
authors.lastname: Hosing
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D064592:Autografts; D002648:Child; D005260:Female; D006801:Humans; D015994:Incidence; D015470:Leukemia, Myeloid, Acute / Q000453:epidemiology*; D008223:Lymphoma / Q000453:epidemiology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000453:epidemiology*; D016609:Neoplasms, Second Primary / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D033581:Stem Cell Transplantation