TY - JOUR
T1 - Allogeneic Hematopoietic Cell Transplantation for Adult Chronic Myelomonocytic Leukemia
AU - Liu, Hien Duong
AU - Ahn, Kwang Woo
AU - Hu, Zhen Huan
AU - Hamadani, Mehdi
AU - Nishihori, Taiga
AU - Wirk, Baldeep
AU - Beitinjaneh, Amer
AU - Rizzieri, David
AU - Grunwald, Michael R.
AU - Sabloff, Mitchell
AU - Olsson, Richard F.
AU - Bajel, Ashish
AU - Bredeson, Christopher
AU - Daly, Andrew
AU - Inamoto, Yoshihiro
AU - Majhail, Navneet
AU - Saad, Ayman
AU - Gupta, Vikas
AU - Gerds, Aaron
AU - Malone, Adriana
AU - Tallman, Martin
AU - Reshef, Ran
AU - Marks, David I.
AU - Copelan, Edward
AU - Gergis, Usama
AU - Savoie, Mary Lynn
AU - Ustun, Celalettin
AU - Litzow, Mark R.
AU - Cahn, Jean Yves
AU - Kindwall-Keller, Tamila
AU - Akpek, Gorgun
AU - Savani, Bipin N.
AU - Aljurf, Mahmoud
AU - Rowe, Jacob M.
AU - Wiernik, Peter H.
AU - Hsu, Jack W.
AU - Cortes, Jorge
AU - Kalaycio, Matt
AU - Maziarz, Richard
AU - Sobecks, Ronald
AU - Popat, Uday
AU - Alyea, Edwin
AU - Saber, Wael
N1 - Publisher Copyright:
© 2017 The American Society for Blood and Marrow Transplantation
PY - 2017/5/1
Y1 - 2017/5/1
N2 - Allogeneic hematopoietic cell transplantation (HCT) is potentially curative for patients with chronic myelomonocytic leukemia (CMML); however, few data exist regarding prognostic factors and transplantation outcomes. We performed this retrospective study to identify prognostic factors for post-transplantation outcomes. The CMML-specific prognostic scoring system (CPSS) has been validated in subjects receiving nontransplantation therapy and was included in our study. From 2001 to 2012, 209 adult subjects who received HCT for CMML were reported to the Center for International Blood and Marrow Transplant Research. The median age at transplantation was 57 years (range, 23 to 74). Median follow-up was 51 months (range, 3 to 122). On multivariate analyses, CPSS scores, Karnofsky performance status (KPS), and graft source were significant predictors of survival (P = .004, P = .01, P = .01, respectively). Higher CPSS scores were not associated with disease-free survival, relapse, or transplantation-related mortality. In a restricted analysis of subjects with relapse after HCT, those with intermediate-2/high risk had a nearly 2-fold increased risk of death after relapse compared to those with low/intermediate-1 CPSS scores. Respective 1-year, 3-year, and 5-year survival rates for low/intermediate-1 risk subjects were 61% (95% confidence interval [CI], 52% to 72%), 48% (95% CI, 37% to 59%), and 44% (95% CI, 33% to 55%), and for intermediate-2/high risk subjects were 38% (95% CI, 28% to 49%), 32% (95% CI, 21% to 42%), and 19% (95% CI, 8% to 29%). We conclude that higher CPSS score at time of transplantation, lower KPS, and a bone marrow graft are associated with inferior survival after HCT. Further investigation of CMML disease–related biology may provide insights into other risk factors predictive of post-transplantation outcomes.
AB - Allogeneic hematopoietic cell transplantation (HCT) is potentially curative for patients with chronic myelomonocytic leukemia (CMML); however, few data exist regarding prognostic factors and transplantation outcomes. We performed this retrospective study to identify prognostic factors for post-transplantation outcomes. The CMML-specific prognostic scoring system (CPSS) has been validated in subjects receiving nontransplantation therapy and was included in our study. From 2001 to 2012, 209 adult subjects who received HCT for CMML were reported to the Center for International Blood and Marrow Transplant Research. The median age at transplantation was 57 years (range, 23 to 74). Median follow-up was 51 months (range, 3 to 122). On multivariate analyses, CPSS scores, Karnofsky performance status (KPS), and graft source were significant predictors of survival (P = .004, P = .01, P = .01, respectively). Higher CPSS scores were not associated with disease-free survival, relapse, or transplantation-related mortality. In a restricted analysis of subjects with relapse after HCT, those with intermediate-2/high risk had a nearly 2-fold increased risk of death after relapse compared to those with low/intermediate-1 CPSS scores. Respective 1-year, 3-year, and 5-year survival rates for low/intermediate-1 risk subjects were 61% (95% confidence interval [CI], 52% to 72%), 48% (95% CI, 37% to 59%), and 44% (95% CI, 33% to 55%), and for intermediate-2/high risk subjects were 38% (95% CI, 28% to 49%), 32% (95% CI, 21% to 42%), and 19% (95% CI, 8% to 29%). We conclude that higher CPSS score at time of transplantation, lower KPS, and a bone marrow graft are associated with inferior survival after HCT. Further investigation of CMML disease–related biology may provide insights into other risk factors predictive of post-transplantation outcomes.
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U2 - 10.1016/j.bbmt.2017.01.078
DO - 10.1016/j.bbmt.2017.01.078
M3 - Article
C2 - 28115276
AN - SCOPUS:85014101308
SN - 1083-8791
VL - 23
SP - 767
EP - 775
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
IS - 5
ER -