title: Therapy-related acute myeloid leukemia and myelodysplastic syndrome after hematopoietic cell transplantation for lymphoma.
abstract: Therapy-related acute myeloid leukemia and myelodysplastic syndrome (t-AML/MDS) represent severe late effects in patients receiving hematopoietic cell transplantation (HCT) for lymphoma. The choice between high-dose therapy with autologous HCT and allogeneic HCT with reduced-intensity conditioning remains controversial in patients with relapsed lymphoma. We retrospectively analyzed incidence and risk factors for the development of t-AML/MDS in lymphoma patients treated with autologous or allogeneic HCT. A total of 13 810 lymphoma patients who received autologous (n=9963) or allogeneic (n=3847) HCT between 1985 and 2012 were considered. At a median overall survival (OS) of 52 and 46 months in autologous and allogeneic HCT groups, respectively, lymphoma patients receiving autologous HCT (1.38% at 3 years after autologous HCT) had a significant risk for developing t-AML/MDS compared to allogeneic HCT (0.37% at 3 years after allogeneic HCT, P<0.001). Significant risk factors for the development of t-AML/MDS after autologous and allogeneic HCT were high-stage risk at HCT (P=0.04) or secondary malignancies (P<0.001) and receiving cord blood stem cell (P=0.03) or involved field radiotherapy (P=0.002), respectively. Strategies that carefully select lymphoma patients for autologous HCT, by excluding lymphoma patients with high-stage risk at HCT, may allow the identification of individual lymphoma patients at particular high risk for t-AML/MDS.
authors.affiliation: Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Yamasaki
authors.affiliation: Department of Oncology and Haematology, Shimane University Hospital, Izumo, Japan.
authors.forename: R
authors.initials: R
authors.lastname: Suzuki
authors.affiliation: Division of Hematology and Cell Therapy, Jichi Medical University, Shimotsuke, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Hatano
authors.affiliation: Division of Hematology, Rinku General Medical Center, Izumisano, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Fukushima
authors.affiliation: Division of Cell Therapy, National Hospital Organization Nagoya Medical Center, Nagoya, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Iida
authors.affiliation: Department of Hematology and Oncology, Fujita Health University School of Medicine, Toyoake, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Morishima
authors.affiliation: Department of Hematology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Suehiro
authors.affiliation: Division of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Fukuda
authors.affiliation: Department of Hematology, Federation of National Public Service Personnel Mutual Aid Associations Toranomon Hospital, Tokyo, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Uchida
authors.affiliation: Department of Hematology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Uchiyama
authors.affiliation: Department of Gastroenterology, Rheumatology and Clinical Immunology, Sapporo Medical University Hospital, Sapporo, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Ikeda
authors.affiliation: Department of Hematology, Chiba Aoba Municipal Hospital, Chiba, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Yokota
authors.affiliation: Hematology Division, National Cancer Center Hospital East, Kashiwa, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Tsukasaki
authors.affiliation: Department of Hematology, Nippon Medical School, Tokyo, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Yamaguchi
authors.affiliation: Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: J
authors.initials: J
authors.lastname: Kuroda
authors.affiliation: Department of Hematology, Osaka City University Hospital, Osaka, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Nakamae
authors.affiliation: Department of Internal Medicine, Japan Community Health Care Organization Kobe Central Hospital, Kobe, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Adachi
authors.affiliation: Division of Hematology and Oncology, Okayama University Hospital, Okayama, Japan.
authors.forename: K-I
authors.initials: KI
authors.lastname: Matsuoka
authors.affiliation: Third Department of Internal of Medicine, Yamaguchi University School of Medicine, Ube, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Nakamura
authors.affiliation: Department of Healthcare Administration, Nagoya University Graduate School of Medicine and Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Atsuta
authors.affiliation: Department of Oncology and Haematology, Shimane University Hospital, Izumo, Japan.
authors.forename: J
authors.initials: J
authors.lastname: Suzumiya
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D064591:Allografts; D064592:Autografts; D005260:Female; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; 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*; D012307:Risk Factors