Allogeneic hematopoietic stem cell transplant in adult patients with myelodysplastic syndrome/myeloproliferative neoplasm (MDS/MPN) overlap syndromes

Prashant Sharma, Shivani S. Shinde, Moussab Damlaj, Mehrdad Hefazi Rorghabeh, Shahrukh K. Hashmi, Mark R. Litzow, William J. Hogan, Naseema Gangat, Michelle A. Elliott, Aref Al-Kali, Ayalew Tefferi, Mrinal M. Patnaik

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

Abstract

MDS/MPN (myelodysplastic syndrome/myeloproliferative neoplasm) overlap syndromes are myeloid malignancies for which allogeneic hematopoietic stem cell transplant (allo-HSCT) is potentially curative. We describe transplant outcomes of 43 patients–35 with chronic myelomonocytic leukemia, CMML (of which 17 had blast transformation, BT) and eight with MDS/MPN-unclassifiable (MDS/MPN,U). At median follow-up of 21 months, overall survival (OS), cumulative incidence of relapse (CIR) and non-relapse mortality (NRM) were 55%, 29%, and 25% respectively in CMML without BT and 47%, 40%, and 34% respectively in CMML with BT. Higher HSCT-comorbidity index (HSCT-CI >3 versus ≤3; p = 0.015) and splenomegaly (p = 0.006) predicted worse OS in CMML without BT. In CMML with BT, engraftment failure (p = 0.006) and higher HSCT-CI (p = 0.03) were associated with inferior OS, while HSCT within 1-year of diagnosis was associated with improved OS (p = 0.045). In MDS/MPN,U, at median follow-up of 15 months, OS, CIR, and NRM were 62%, 30%, and 14%, respectively.

Original languageEnglish (US)
Pages (from-to)872-881
Number of pages10
JournalLeukemia and Lymphoma
Volume58
Issue number4
DOIs
StatePublished - Apr 3 2017

Keywords

  • MDS/MPN overlap syndrome
  • MDS/MPN-unclassifiable
  • allogeneic hematopoietic stem cell transplant
  • chronic myelomonocytic leukemia (CMML)

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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