Low incidence of myelodysplasia or acute leukemia after autologous blood and marrow transplant without total body radiation for lymphoma

A. Alhoinaidhi, M. Crump, K. Imrie, Alexander Keith Stewart, J. Brandwein, J. Squire, A. Keating

Research output: Contribution to journalArticle

Abstract

We evaluated the incidence of myelodysplastic syndrome and acute myeloid leukemia (MDS/AML) in long term survivors following high dose chemotherapy and autologous blood and marrow transplantation (ABMT) for relapsed or refractory Hodgkin's disease (HD) or non-Hodgkin's lymphoma (NHL), using a regimen that does not employ total body irradiation (TBI). From 12/1986 to 12/1995, 309 patients (pts) (148 HD, 156 NHL, 5 discordant lymphoma) received etoposide 60 mg/kg + melphalan 160 -180 mg/m2 supported by autologous bone marrow or blood cells including 51 pts with low or high grade NHL who also received TBI 2 Gy twice daily × 6 fractions. 139β09 pts (45 %) are continuously disease free (DF) > I year post ABMT (median follow-up 45 months, range 12-120). Seven pts have developed MDS (5 pts) or AML (2 pts) after ABMT, six were free of lymphoma at diagnosis of secondary leukemia and one pt developed MDS following radiation for local relapse. None of the pts who developed MDS/AML had received TBI. The crude rate of MDS/AML at 5 years post-ABMT in the overall group is 2.3 % (95% C I; 1.1- 4.6%). Actuarial probability of a clonal bone marrow disorder in pts who remain DF is 7 % (± 3 %SE) at 4 years. Of the 4 pts with MDS/AML who had marrow cytogenetics performed, 2 had monosomy 7, one had 1 Iql3 and one pt had Hq23 rearrangement in addition to trisomy 8. All also had other chromosomal abnormalities. Studies are in progress using interphase fluorescence in-situ hybridization (FISH) to detect karyotypic abnormalities earlier in the post-transplant cohort. Compared to previous reports, MDS/AML is less common after ABMT with etoposide + melphalan in pts with lymphoma, but can arise in pts who do not receive TBI.

Original languageEnglish (US)
Pages (from-to)820
Number of pages1
JournalExperimental Hematology
Volume25
Issue number8
StatePublished - 1997
Externally publishedYes

Fingerprint

Lymphoma
Leukemia
Bone Marrow
Radiation
Transplants
Incidence
Myelodysplastic Syndromes
Acute Myeloid Leukemia
Whole-Body Irradiation
Transplantation
Non-Hodgkin's Lymphoma
Melphalan
Etoposide
Hodgkin Disease
Interphase
Fluorescence In Situ Hybridization
Cytogenetics
Chromosome Aberrations
Bone Marrow Cells
Survivors

ASJC Scopus subject areas

  • Cancer Research
  • Cell Biology
  • Genetics
  • Hematology
  • Oncology
  • Transplantation

Cite this

Low incidence of myelodysplasia or acute leukemia after autologous blood and marrow transplant without total body radiation for lymphoma. / Alhoinaidhi, A.; Crump, M.; Imrie, K.; Stewart, Alexander Keith; Brandwein, J.; Squire, J.; Keating, A.

In: Experimental Hematology, Vol. 25, No. 8, 1997, p. 820.

Research output: Contribution to journalArticle

Alhoinaidhi, A. ; Crump, M. ; Imrie, K. ; Stewart, Alexander Keith ; Brandwein, J. ; Squire, J. ; Keating, A. / Low incidence of myelodysplasia or acute leukemia after autologous blood and marrow transplant without total body radiation for lymphoma. In: Experimental Hematology. 1997 ; Vol. 25, No. 8. pp. 820.
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