Hematopoietic stem cell transplantation in children and young adults with secondary myelodysplastic syndrome and acute myelogenous leukemia after aplastic anemia

Yoshimi A, Strahm B, Baumann I, Furlan I, Schwarz-Furlan S, Teigler-Schlegel A, Walther JU, Schlegelberger B, Göhring G, Nöllke P, Führer M, Niemeyer CM (2014)

Publication Type: Journal article

Publication year: 2014

Journal

Biology of Blood and Marrow Transplantation Elsevier

Publisher: Elsevier

Book Volume: 20

Pages Range: 425-9

Journal Issue: 3

DOI: 10.1016/j.bbmt.2013.11.031

Abstract

Secondary myelodysplastic syndrome and acute myelogenous leukemia (sMDS/sAML) are the most serious secondary events occurring after immunosuppressive therapy in patients with aplastic anemia. Here we evaluate the outcome of hematopoietic stem cell transplantation (HSCT) in 17 children and young adults with sMDS/sAML after childhood aplastic anemia. The median interval between the diagnosis of aplastic anemia and the development of sMDS/sAML was 2.9 years (range, 1.2 to 13.0 years). At a median age of 13.1 years (range, 4.4 to 26.7 years), patients underwent HSCT with bone marrow (n = 6) or peripheral blood stem cell (n = 11) grafts from HLA-matched sibling donors (n = 2), mismatched family donors (n = 2), or unrelated donors (n = 13). Monosomy 7 was detected in 13 patients. The preparative regimen consisted of busulfan, cyclophosphamide, and melphalan in 11 patients and other agents in 6 patients. All patients achieved neutrophil engraftment. The cumulative incidence of grade II-IV acute graft-versus-host disease (GVHD) was 47%, and that of chronic GVHD was 70%. Relapse occurred in 1 patient. The major cause of death was transplant-related complication (n = 9). Overall survival and event-free survival at 5 years after HSCT were both 41%. In summary, this study indicates that HSCT is a curative therapy for some patients with sMDS/sAML after aplastic anemia. Future efforts should focus on reducing transplantation-related mortality.

Authors with CRIS profile

Stephan Schwarz-Furlan Medizinische Fakultät

Involved external institutions

Albert-Ludwigs-Universität Freiburg DE Germany (DE) Klinikverbund Südwest (Sindelfingen-Böblingen, Calw, Nagold, Leonberg, Herrenberg) DE Germany (DE) Universitätsklinikum Ulm DE Germany (DE) Universitätsklinikum Gießen und Marburg (UKGM) DE Germany (DE) Ludwig-Maximilians-Universität (LMU) DE Germany (DE) Medizinische Hochschule Hannover (MHH) / Hannover Medical School DE Germany (DE)

How to cite

APA:

Yoshimi, A., Strahm, B., Baumann, I., Furlan, I., Schwarz-Furlan, S., Teigler-Schlegel, A.,... Niemeyer, C.M. (2014). Hematopoietic stem cell transplantation in children and young adults with secondary myelodysplastic syndrome and acute myelogenous leukemia after aplastic anemia. Biology of Blood and Marrow Transplantation, 20(3), 425-9. https://doi.org/10.1016/j.bbmt.2013.11.031

MLA:

Yoshimi, Ayami, et al. "Hematopoietic stem cell transplantation in children and young adults with secondary myelodysplastic syndrome and acute myelogenous leukemia after aplastic anemia." Biology of Blood and Marrow Transplantation 20.3 (2014): 425-9.

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