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Risk of acute myeloid leukemia and myelodysplastic syndrome after autotransplants for lymphomas and plasma cell myeloma
Cleveland Clin Fdn, Dept Quantitat Hlth Sci, 9500 Euclid Ave, Cleveland, OH 44195 USA;Cleveland Clin Fdn, Dept Hematol & Oncol Res, 9500 Euclid Ave, Cleveland, OH 44195 USA.ORCID iD: 0000-0002-9701-1851
Cleveland Clin, Blood & Marrow Transplant Program, Cleveland, OH 44106 USA;Royal Melbourne Hosp City Campus, Melbourne, Vic, Australia.
Med Coll Wisconsin, CIBMTR, Milwaukee, WI 53226 USA.
Med Coll Wisconsin, CIBMTR, Milwaukee, WI 53226 USA;Med Coll Wisconsin, Div Biostat, Milwaukee, WI 53226 USA.
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2018 (English)In: Leukemia research: a Forum for Studies on Leukemia and Normal Hemopoiesis, ISSN 0145-2126, E-ISSN 1873-5835, Vol. 74, p. 130-136Article in journal (Refereed) Published
Abstract [en]

Background: Exposures to DNA-damaging drugs and ionizing radiations increase risks of acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS).

Methods: 9028 recipients of hematopoietic cell autotransplants (1995-2010) for Hodgkin lymphoma (HL; n=916), non-Hodgkin lymphoma (NHL; n=3546) and plasma cell myeloma (PCM; n=4566), reported to the CIBMTR, were analyzed for risk of subsequent AML or MDS.

Results: 335 MDS/ AML cases were diagnosed posttransplant (3.7%). Variables associated with an increased risk for AML or MDS in multivariate analyses were: (1) conditioning with total body radiation versus chemotherapy alone for HL (HR=4.0; 95% confidence interval [1.4, 11.6]) and NHL (HR=2.5 [1.1, 2.5]); (2) >= 3 versus 1 line of chemotherapy for NHL (HR=1.9 [1.3, 2.8]); and (3) subjects with NHL transplanted in 2005-2010 versus 1995-1999 (HR=2.1 [1.5, 3.1]). Using Surveillance, Epidemiology and End Results (SEER) data, we found risks for AML/ MDS in HL, NHL and PCM to be 5-10 times the background rate. In contrast, relative risks were 10-50 for AML and approximately 100 for MDS in the autotransplant cohort.

Conclusions: There are substantial risks of AML and MDS after autotransplants for HL, NHL and PCM.

Place, publisher, year, edition, pages
2018. Vol. 74, p. 130-136
Keywords [en]
Autotransplant, AML, MDS, CIBMTR, SEER, Therapy-related, New cancers
National Category
Cancer and Oncology Hematology
Identifiers
URN: urn:nbn:se:uu:diva-369596DOI: 10.1016/j.leukres.2018.07.016ISI: 000449112000021PubMedID: 30055822OAI: oai:DiVA.org:uu-369596DiVA, id: diva2:1272469
Available from: 2018-12-19 Created: 2018-12-19 Last updated: 2018-12-19Bibliographically approved

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Olsson, Richard F.

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Radivoyevitch, TomasOlsson, Richard F.
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