Risk of acute myeloid leukemia and myelodysplastic syndrome after autotransplants for lymphomas and plasma cell myeloma

Tomas Radivoyevitch; Robert M. Dean; Bronwen E. Shaw; Ruta Brazauskas; Heather R. Tecca; Remco J. Molenaar; Minoo Battiwalla; Bipin N. Savani; Mary E.D. Flowers; Kenneth R. Cooke; Betty K. Hamilton; Matt Kalaycio; Jaroslaw P. Maciejewski; Ibrahim Ahmed; Görgün Akpek; Ashish Bajel; David Buchbinder; Jean Yves Cahn; Anita D'Souza; Andrew Daly; Zachariah DeFilipp; Siddhartha Ganguly; Mehdi Hamadani; Robert J. Hayashi; Peiman Hematti; Yoshihiro Inamoto; Nandita Khera; Tamila Kindwall-Keller; Heather Landau; Hillard Lazarus; Navneet S. Majhail; David I. Marks; Richard F. Olsson; Sachiko Seo; Amir Steinberg; Basem M. William; Baldeep Wirk; Jean A. Yared; Mahmoud Aljurf; Muneer H. Abidi; Heather Allewelt; Amer Beitinjaneh; Rachel Cook; Robert F. Cornell; Joseph W. Fay; Gregory Hale; Jennifer Holter Chakrabarty; Sonata Jodele; Kimberly A. Kasow; Anuj Mahindra; Adriana K. Malone; Uday Popat; J. Douglas Rizzo; Harry C. Schouten; Anne B. Warwick; William A. Wood; Mikkael A. Sekeres; Mark R. Litzow; Robert P. Gale; Shahrukh K. Hashmi

doi:10.1016/j.leukres.2018.07.016

Risk of acute myeloid leukemia and myelodysplastic syndrome after autotransplants for lymphomas and plasma cell myeloma

Tomas Radivoyevitch, Robert M. Dean, Bronwen E. Shaw, Ruta Brazauskas, Heather R. Tecca, Remco J. Molenaar, Minoo Battiwalla, Bipin N. Savani, Mary E.D. Flowers, Kenneth R. Cooke, Betty K. Hamilton, Matt Kalaycio, Jaroslaw P. Maciejewski, Ibrahim Ahmed, Görgün Akpek, Ashish Bajel, David Buchbinder, Jean Yves Cahn, Anita D'Souza, Andrew DalyZachariah DeFilipp, Siddhartha Ganguly, Mehdi Hamadani, Robert J. Hayashi, Peiman Hematti, Yoshihiro Inamoto, Nandita Khera, Tamila Kindwall-Keller, Heather Landau, Hillard Lazarus, Navneet S. Majhail, David I. Marks, Richard F. Olsson, Sachiko Seo, Amir Steinberg, Basem M. William, Baldeep Wirk, Jean A. Yared, Mahmoud Aljurf, Muneer H. Abidi, Heather Allewelt, Amer Beitinjaneh, Rachel Cook, Robert F. Cornell, Joseph W. Fay, Gregory Hale, Jennifer Holter Chakrabarty, Sonata Jodele, Kimberly A. Kasow, Anuj Mahindra, Adriana K. Malone, Uday Popat, J. Douglas Rizzo, Harry C. Schouten, Anne B. Warwick, William A. Wood, Mikkael A. Sekeres, Mark R. Litzow, Robert P. Gale, Shahrukh K. Hashmi

Research output: Contribution to journal › Article › peer-review

15 Scopus citations

Abstract

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.

Original language	English (US)
Pages (from-to)	130-136
Number of pages	7
Journal	Leukemia Research
Volume	74
DOIs	https://doi.org/10.1016/j.leukres.2018.07.016
State	Published - Nov 2018

Keywords

AML
Autotransplant
CIBMTR
MDS
New cancers
SEER
Therapy-related

ASJC Scopus subject areas

Hematology
Oncology
Cancer Research

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10.1016/j.leukres.2018.07.016

Cite this

Radivoyevitch, T., Dean, R. M., Shaw, B. E., Brazauskas, R., Tecca, H. R., Molenaar, R. J., Battiwalla, M., Savani, B. N., Flowers, M. E. D., Cooke, K. R., Hamilton, B. K., Kalaycio, M., Maciejewski, J. P., Ahmed, I., Akpek, G., Bajel, A., Buchbinder, D., Cahn, J. Y., D'Souza, A., ... Hashmi, S. K. (2018). Risk of acute myeloid leukemia and myelodysplastic syndrome after autotransplants for lymphomas and plasma cell myeloma. Leukemia Research, 74, 130-136. https://doi.org/10.1016/j.leukres.2018.07.016

Risk of acute myeloid leukemia and myelodysplastic syndrome after autotransplants for lymphomas and plasma cell myeloma. / Radivoyevitch, Tomas; Dean, Robert M.; Shaw, Bronwen E.; Brazauskas, Ruta; Tecca, Heather R.; Molenaar, Remco J.; Battiwalla, Minoo; Savani, Bipin N.; Flowers, Mary E.D.; Cooke, Kenneth R.; Hamilton, Betty K.; Kalaycio, Matt; Maciejewski, Jaroslaw P.; Ahmed, Ibrahim; Akpek, Görgün; Bajel, Ashish; Buchbinder, David; Cahn, Jean Yves; D'Souza, Anita; Daly, Andrew; DeFilipp, Zachariah; Ganguly, Siddhartha; Hamadani, Mehdi; Hayashi, Robert J.; Hematti, Peiman; Inamoto, Yoshihiro; Khera, Nandita; Kindwall-Keller, Tamila; Landau, Heather; Lazarus, Hillard; Majhail, Navneet S.; Marks, David I.; Olsson, Richard F.; Seo, Sachiko; Steinberg, Amir; William, Basem M.; Wirk, Baldeep; Yared, Jean A.; Aljurf, Mahmoud; Abidi, Muneer H.; Allewelt, Heather; Beitinjaneh, Amer; Cook, Rachel; Cornell, Robert F.; Fay, Joseph W.; Hale, Gregory; Chakrabarty, Jennifer Holter; Jodele, Sonata; Kasow, Kimberly A.; Mahindra, Anuj; Malone, Adriana K.; Popat, Uday; Rizzo, J. Douglas; Schouten, Harry C.; Warwick, Anne B.; Wood, William A.; Sekeres, Mikkael A.; Litzow, Mark R.; Gale, Robert P.; Hashmi, Shahrukh K.

In: Leukemia Research, Vol. 74, 11.2018, p. 130-136.

Research output: Contribution to journal › Article › peer-review

Radivoyevitch, T, Dean, RM, Shaw, BE, Brazauskas, R, Tecca, HR, Molenaar, RJ, Battiwalla, M, Savani, BN, Flowers, MED, Cooke, KR, Hamilton, BK, Kalaycio, M, Maciejewski, JP, Ahmed, I, Akpek, G, Bajel, A, Buchbinder, D, Cahn, JY, D'Souza, A, Daly, A, DeFilipp, Z, Ganguly, S, Hamadani, M, Hayashi, RJ, Hematti, P, Inamoto, Y, Khera, N, Kindwall-Keller, T, Landau, H, Lazarus, H, Majhail, NS, Marks, DI, Olsson, RF, Seo, S, Steinberg, A, William, BM, Wirk, B, Yared, JA, Aljurf, M, Abidi, MH, Allewelt, H, Beitinjaneh, A, Cook, R, Cornell, RF, Fay, JW, Hale, G, Chakrabarty, JH, Jodele, S, Kasow, KA, Mahindra, A, Malone, AK, Popat, U, Rizzo, JD, Schouten, HC, Warwick, AB, Wood, WA, Sekeres, MA, Litzow, MR, Gale, RP & Hashmi, SK 2018, 'Risk of acute myeloid leukemia and myelodysplastic syndrome after autotransplants for lymphomas and plasma cell myeloma', Leukemia Research, vol. 74, pp. 130-136. https://doi.org/10.1016/j.leukres.2018.07.016

Radivoyevitch, Tomas ; Dean, Robert M. ; Shaw, Bronwen E. ; Brazauskas, Ruta ; Tecca, Heather R. ; Molenaar, Remco J. ; Battiwalla, Minoo ; Savani, Bipin N. ; Flowers, Mary E.D. ; Cooke, Kenneth R. ; Hamilton, Betty K. ; Kalaycio, Matt ; Maciejewski, Jaroslaw P. ; Ahmed, Ibrahim ; Akpek, Görgün ; Bajel, Ashish ; Buchbinder, David ; Cahn, Jean Yves ; D'Souza, Anita ; Daly, Andrew ; DeFilipp, Zachariah ; Ganguly, Siddhartha ; Hamadani, Mehdi ; Hayashi, Robert J. ; Hematti, Peiman ; Inamoto, Yoshihiro ; Khera, Nandita ; Kindwall-Keller, Tamila ; Landau, Heather ; Lazarus, Hillard ; Majhail, Navneet S. ; Marks, David I. ; Olsson, Richard F. ; Seo, Sachiko ; Steinberg, Amir ; William, Basem M. ; Wirk, Baldeep ; Yared, Jean A. ; Aljurf, Mahmoud ; Abidi, Muneer H. ; Allewelt, Heather ; Beitinjaneh, Amer ; Cook, Rachel ; Cornell, Robert F. ; Fay, Joseph W. ; Hale, Gregory ; Chakrabarty, Jennifer Holter ; Jodele, Sonata ; Kasow, Kimberly A. ; Mahindra, Anuj ; Malone, Adriana K. ; Popat, Uday ; Rizzo, J. Douglas ; Schouten, Harry C. ; Warwick, Anne B. ; Wood, William A. ; Sekeres, Mikkael A. ; Litzow, Mark R. ; Gale, Robert P. ; Hashmi, Shahrukh K. / Risk of acute myeloid leukemia and myelodysplastic syndrome after autotransplants for lymphomas and plasma cell myeloma. In: Leukemia Research. 2018 ; Vol. 74. pp. 130-136.

@article{e000d8ebf6564150ad177a23a30125a5,

title = "Risk of acute myeloid leukemia and myelodysplastic syndrome after autotransplants for lymphomas and plasma cell myeloma",

abstract = "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.",

keywords = "AML, Autotransplant, CIBMTR, MDS, New cancers, SEER, Therapy-related",

author = "Tomas Radivoyevitch and Dean, {Robert M.} and Shaw, {Bronwen E.} and Ruta Brazauskas and Tecca, {Heather R.} and Molenaar, {Remco J.} and Minoo Battiwalla and Savani, {Bipin N.} and Flowers, {Mary E.D.} and Cooke, {Kenneth R.} and Hamilton, {Betty K.} and Matt Kalaycio and Maciejewski, {Jaroslaw P.} and Ibrahim Ahmed and G{\"o}rg{\"u}n Akpek and Ashish Bajel and David Buchbinder and Cahn, {Jean Yves} and Anita D'Souza and Andrew Daly and Zachariah DeFilipp and Siddhartha Ganguly and Mehdi Hamadani and Hayashi, {Robert J.} and Peiman Hematti and Yoshihiro Inamoto and Nandita Khera and Tamila Kindwall-Keller and Heather Landau and Hillard Lazarus and Majhail, {Navneet S.} and Marks, {David I.} and Olsson, {Richard F.} and Sachiko Seo and Amir Steinberg and William, {Basem M.} and Baldeep Wirk and Yared, {Jean A.} and Mahmoud Aljurf and Abidi, {Muneer H.} and Heather Allewelt and Amer Beitinjaneh and Rachel Cook and Cornell, {Robert F.} and Fay, {Joseph W.} and Gregory Hale and Chakrabarty, {Jennifer Holter} and Sonata Jodele and Kasow, {Kimberly A.} and Anuj Mahindra and Malone, {Adriana K.} and Uday Popat and Rizzo, {J. Douglas} and Schouten, {Harry C.} and Warwick, {Anne B.} and Wood, {William A.} and Sekeres, {Mikkael A.} and Litzow, {Mark R.} and Gale, {Robert P.} and Hashmi, {Shahrukh K.}",

note = "Funding Information: The CIBMTR is supported primarily by Public Health Service Grant/Cooperative Agreement 5U24CA076518 from the National Cancer Institute (NCI), the National Heart, Lung and Blood Institute (NHLBI) and the National Institute of Allergy and Infectious Diseases (NIAID); a Grant/Cooperative Agreement 4U10HL069294 from NHLBI and NCI; a contract HHSH250201200016C with Health Resources and Services Administration (HRSA/DHHS); two Grants N00014-17-1?2388 and N0014-17-1?2850 from the Office of Naval Research; and grants from *Actinium Pharmaceuticals, Inc.; *Amgen, Inc.; *Amneal Biosciences; *Angiocrine Bioscience, Inc.; Anonymous donation to the Medical College of Wisconsin; Astellas Pharma US; Atara Biotherapeutics, Inc.; Be the Match Foundation; *bluebird bio, Inc.; *Bristol Myers Squibb Oncology; *Celgene Corporation; Cerus Corporation; *Chimerix, Inc.; Fred Hutchinson Cancer Research Center; Gamida Cell Ltd.; Gilead Sciences, Inc.; HistoGenetics, Inc.; Immucor; *Incyte Corporation; Janssen Scientific Affairs, LLC; *Jazz Pharmaceuticals, Inc.; Juno Therapeutics; Karyopharm Therapeutics, Inc.; Kite Pharma, Inc.; Medac, GmbH; MedImmune; The Medical College of Wisconsin; *Mediware; *Merck & Co, Inc.; *Mesoblast; MesoScale Diagnostics, Inc.; Millennium, the Takeda Oncology Co.; *Miltenyi Biotec, Inc.; National Marrow Donor Program; *Neovii Biotech NA, Inc.; Novartis Pharmaceuticals Corporation; Otsuka Pharmaceutical Co, Ltd. ? Japan; PCORI; *Pfizer, Inc; *Pharmacyclics, LLC; PIRCHE AG; *Sanofi Genzyme; *Seattle Genetics; Shire; Spectrum Pharmaceuticals, Inc.; St. Baldrick's Foundation; *Sunesis Pharmaceuticals, Inc.; Swedish Orphan Biovitrum, Inc.; Takeda Oncology; Telomere Diagnostics, Inc.; and University of Minnesota. The views expressed in this article do not reflect the official policy or position of the National Institute of Health, the Department of the Navy, the Department of Defense, Health Resources and Services Administration (HRSA) or any other agency of the U.S. Government. TR is supported by the National Aeronautics and Space Administration (NNJ13ZSA001N). RPG acknowledges support from the National Institute of Health Research (NIHR) Biomedical Research Centre funding scheme. *Corporate Members Funding Information: The CIBMTR is supported primarily by Public Health Service Grant/Cooperative Agreement 5U24CA076518 from the National Cancer Institute (NCI) , the National Heart , Lung and Blood Institute (NHLBI) and the National Institute of Allergy and Infectious Diseases (NIAID) ; a Grant/Cooperative Agreement 4U10HL069294 from NHLBI and NCI; a contract HHSH250201200016C with Health Resources and Services Administration (HRSA/DHHS); two Grants N00014-17-1–2388 and N0014-17-1–2850 from the Office of Naval Research; and grants from *Actinium Pharmaceuticals, Inc.; *Amgen, Inc.; *Amneal Biosciences; *Angiocrine Bioscience, Inc.; Anonymous donation to the Medical College of Wisconsin; Astellas Pharma US; Atara Biotherapeutics, Inc.; Be the Match Foundation; *bluebird bio, Inc.; *Bristol Myers Squibb Oncology; *Celgene Corporation; Cerus Corporation; *Chimerix, Inc.; Fred Hutchinson Cancer Research Center; Gamida Cell Ltd.; Gilead Sciences, Inc.; HistoGenetics, Inc.; Immucor; *Incyte Corporation; Janssen Scientific Affairs, LLC; *Jazz Pharmaceuticals, Inc.; Juno Therapeutics; Karyopharm Therapeutics, Inc.; Kite Pharma, Inc.; Medac, GmbH; MedImmune; The Medical College of Wisconsin; *Mediware; *Merck & Co, Inc.; *Mesoblast; MesoScale Diagnostics, Inc.; Millennium, the Takeda Oncology Co.; *Miltenyi Biotec, Inc.; National Marrow Donor Program; *Neovii Biotech NA, Inc.; Novartis Pharmaceuticals Corporation; Otsuka Pharmaceutical Co, Ltd. – Japan; PCORI; *Pfizer, Inc; *Pharmacyclics, LLC; PIRCHE AG; *Sanofi Genzyme; *Seattle Genetics; Shire; Spectrum Pharmaceuticals, Inc.; St. Baldrick{\textquoteright}s Foundation; *Sunesis Pharmaceuticals, Inc.; Swedish Orphan Biovitrum, Inc.; Takeda Oncology; Telomere Diagnostics, Inc.; and University of Minnesota. The views expressed in this article do not reflect the official policy or position of the National Institute of Health, the Department of the Navy, the Department of Defense, Health Resources and Services Administration (HRSA) or any other agency of the U.S. Government. TR is supported by the National Aeronautics and Space Administration (NNJ13ZSA001N). RPG acknowledges support from the National Institute of Health Research (NIHR) Biomedical Research Centre funding scheme. *Corporate Members Publisher Copyright: {\textcopyright} 2018",

year = "2018",

month = nov,

doi = "10.1016/j.leukres.2018.07.016",

language = "English (US)",

volume = "74",

pages = "130--136",

journal = "Leukemia Research",

issn = "0145-2126",

publisher = "Elsevier Limited",

}

TY - JOUR

T1 - Risk of acute myeloid leukemia and myelodysplastic syndrome after autotransplants for lymphomas and plasma cell myeloma

AU - Radivoyevitch, Tomas

AU - Dean, Robert M.

AU - Shaw, Bronwen E.

AU - Brazauskas, Ruta

AU - Tecca, Heather R.

AU - Molenaar, Remco J.

AU - Battiwalla, Minoo

AU - Savani, Bipin N.

AU - Flowers, Mary E.D.

AU - Cooke, Kenneth R.

AU - Hamilton, Betty K.

AU - Kalaycio, Matt

AU - Maciejewski, Jaroslaw P.

AU - Ahmed, Ibrahim

AU - Akpek, Görgün

AU - Bajel, Ashish

AU - Buchbinder, David

AU - Cahn, Jean Yves

AU - D'Souza, Anita

AU - Daly, Andrew

AU - DeFilipp, Zachariah

AU - Ganguly, Siddhartha

AU - Hamadani, Mehdi

AU - Hayashi, Robert J.

AU - Hematti, Peiman

AU - Inamoto, Yoshihiro

AU - Khera, Nandita

AU - Kindwall-Keller, Tamila

AU - Landau, Heather

AU - Lazarus, Hillard

AU - Majhail, Navneet S.

AU - Marks, David I.

AU - Olsson, Richard F.

AU - Seo, Sachiko

AU - Steinberg, Amir

AU - William, Basem M.

AU - Wirk, Baldeep

AU - Yared, Jean A.

AU - Aljurf, Mahmoud

AU - Abidi, Muneer H.

AU - Allewelt, Heather

AU - Beitinjaneh, Amer

AU - Cook, Rachel

AU - Cornell, Robert F.

AU - Fay, Joseph W.

AU - Hale, Gregory

AU - Chakrabarty, Jennifer Holter

AU - Jodele, Sonata

AU - Kasow, Kimberly A.

AU - Mahindra, Anuj

AU - Malone, Adriana K.

AU - Popat, Uday

AU - Rizzo, J. Douglas

AU - Schouten, Harry C.

AU - Warwick, Anne B.

AU - Wood, William A.

AU - Sekeres, Mikkael A.

AU - Litzow, Mark R.

AU - Gale, Robert P.

AU - Hashmi, Shahrukh K.

N1 - Funding Information: The CIBMTR is supported primarily by Public Health Service Grant/Cooperative Agreement 5U24CA076518 from the National Cancer Institute (NCI), the National Heart, Lung and Blood Institute (NHLBI) and the National Institute of Allergy and Infectious Diseases (NIAID); a Grant/Cooperative Agreement 4U10HL069294 from NHLBI and NCI; a contract HHSH250201200016C with Health Resources and Services Administration (HRSA/DHHS); two Grants N00014-17-1?2388 and N0014-17-1?2850 from the Office of Naval Research; and grants from *Actinium Pharmaceuticals, Inc.; *Amgen, Inc.; *Amneal Biosciences; *Angiocrine Bioscience, Inc.; Anonymous donation to the Medical College of Wisconsin; Astellas Pharma US; Atara Biotherapeutics, Inc.; Be the Match Foundation; *bluebird bio, Inc.; *Bristol Myers Squibb Oncology; *Celgene Corporation; Cerus Corporation; *Chimerix, Inc.; Fred Hutchinson Cancer Research Center; Gamida Cell Ltd.; Gilead Sciences, Inc.; HistoGenetics, Inc.; Immucor; *Incyte Corporation; Janssen Scientific Affairs, LLC; *Jazz Pharmaceuticals, Inc.; Juno Therapeutics; Karyopharm Therapeutics, Inc.; Kite Pharma, Inc.; Medac, GmbH; MedImmune; The Medical College of Wisconsin; *Mediware; *Merck & Co, Inc.; *Mesoblast; MesoScale Diagnostics, Inc.; Millennium, the Takeda Oncology Co.; *Miltenyi Biotec, Inc.; National Marrow Donor Program; *Neovii Biotech NA, Inc.; Novartis Pharmaceuticals Corporation; Otsuka Pharmaceutical Co, Ltd. ? Japan; PCORI; *Pfizer, Inc; *Pharmacyclics, LLC; PIRCHE AG; *Sanofi Genzyme; *Seattle Genetics; Shire; Spectrum Pharmaceuticals, Inc.; St. Baldrick's Foundation; *Sunesis Pharmaceuticals, Inc.; Swedish Orphan Biovitrum, Inc.; Takeda Oncology; Telomere Diagnostics, Inc.; and University of Minnesota. The views expressed in this article do not reflect the official policy or position of the National Institute of Health, the Department of the Navy, the Department of Defense, Health Resources and Services Administration (HRSA) or any other agency of the U.S. Government. TR is supported by the National Aeronautics and Space Administration (NNJ13ZSA001N). RPG acknowledges support from the National Institute of Health Research (NIHR) Biomedical Research Centre funding scheme. *Corporate Members Funding Information: The CIBMTR is supported primarily by Public Health Service Grant/Cooperative Agreement 5U24CA076518 from the National Cancer Institute (NCI) , the National Heart , Lung and Blood Institute (NHLBI) and the National Institute of Allergy and Infectious Diseases (NIAID) ; a Grant/Cooperative Agreement 4U10HL069294 from NHLBI and NCI; a contract HHSH250201200016C with Health Resources and Services Administration (HRSA/DHHS); two Grants N00014-17-1–2388 and N0014-17-1–2850 from the Office of Naval Research; and grants from *Actinium Pharmaceuticals, Inc.; *Amgen, Inc.; *Amneal Biosciences; *Angiocrine Bioscience, Inc.; Anonymous donation to the Medical College of Wisconsin; Astellas Pharma US; Atara Biotherapeutics, Inc.; Be the Match Foundation; *bluebird bio, Inc.; *Bristol Myers Squibb Oncology; *Celgene Corporation; Cerus Corporation; *Chimerix, Inc.; Fred Hutchinson Cancer Research Center; Gamida Cell Ltd.; Gilead Sciences, Inc.; HistoGenetics, Inc.; Immucor; *Incyte Corporation; Janssen Scientific Affairs, LLC; *Jazz Pharmaceuticals, Inc.; Juno Therapeutics; Karyopharm Therapeutics, Inc.; Kite Pharma, Inc.; Medac, GmbH; MedImmune; The Medical College of Wisconsin; *Mediware; *Merck & Co, Inc.; *Mesoblast; MesoScale Diagnostics, Inc.; Millennium, the Takeda Oncology Co.; *Miltenyi Biotec, Inc.; National Marrow Donor Program; *Neovii Biotech NA, Inc.; Novartis Pharmaceuticals Corporation; Otsuka Pharmaceutical Co, Ltd. – Japan; PCORI; *Pfizer, Inc; *Pharmacyclics, LLC; PIRCHE AG; *Sanofi Genzyme; *Seattle Genetics; Shire; Spectrum Pharmaceuticals, Inc.; St. Baldrick’s Foundation; *Sunesis Pharmaceuticals, Inc.; Swedish Orphan Biovitrum, Inc.; Takeda Oncology; Telomere Diagnostics, Inc.; and University of Minnesota. The views expressed in this article do not reflect the official policy or position of the National Institute of Health, the Department of the Navy, the Department of Defense, Health Resources and Services Administration (HRSA) or any other agency of the U.S. Government. TR is supported by the National Aeronautics and Space Administration (NNJ13ZSA001N). RPG acknowledges support from the National Institute of Health Research (NIHR) Biomedical Research Centre funding scheme. *Corporate Members Publisher Copyright: © 2018

PY - 2018/11

Y1 - 2018/11

N2 - 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.

AB - 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.

KW - AML

KW - Autotransplant

KW - CIBMTR

KW - MDS

KW - New cancers

KW - SEER

KW - Therapy-related

UR - http://www.scopus.com/inward/record.url?scp=85050340275&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85050340275&partnerID=8YFLogxK

U2 - 10.1016/j.leukres.2018.07.016

DO - 10.1016/j.leukres.2018.07.016

M3 - Article

C2 - 30055822

AN - SCOPUS:85050340275

VL - 74

SP - 130

EP - 136

JO - Leukemia Research

JF - Leukemia Research

SN - 0145-2126

ER -

Risk of acute myeloid leukemia and myelodysplastic syndrome after autotransplants for lymphomas and plasma cell myeloma

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