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- Title
Allogeneic stem cell transplantation for chronic myelomonocytic leukemia: a report from the Societe Francaise de Greffe de Moelle et de Therapie Cellulaire.
- Authors
Park, Sophie; Labopin, Myriam; Yakoub‐Agha, Ibrahim; Delaunay, Jacques; Dhedin, Nathalie; Deconinck, Eric; Michallet, Mauricette; Robin, Marie; Revel, Thierry; Bernard, Marc; Vey, Norbert; Lioure, Bruno; Lapusan, Simona; Tabrizi, Reza; Bourhis, Jean‐Henri; Huynh, Anne; Beguin, Yves; Socié, Gérard; Dreyfus, François; Fenaux, Pierre
- Abstract
Objectives and methods Chronic myelomonocytic leukemia ( CMML) is a severe disease for which allogeneic stem cell transplantation (allo- SCT) remains the only potentially curative treatment. We describe a retrospective study determining prognostic factors for outcome after allo- SCT in consecutive 73 patients with CMML reported to the SFGM- TC registry between 1992 and 2009. Results At diagnosis, median age was 53 yrs, and 36% patients had palpable splenomegaly (SPM). 48, 13, and 9 patients had good, intermediate, and poor risk karyotype, respectively, according to IPSS, 61% patients had CMML-1, and 39% had CMML-2. 41/31/1 cases had an HLA-identical sibling, an unrelated and haploidentical donor, respectively. 43 patients received reduced-intensity conditioning. With a median follow-up of 23 month, acute grade 2-4 and chronic GVHD developed in 21 and 25 patients, respectively. The 3-year OS, NRM (non-relapse mortality), EFS, and CIR (cumulative incidence of relapse) were 32%, 36%, 29% and 35%, respectively. OS was not influenced by the CR status, marrow blasts% at allo-SCT, prior treatments, and cGVHD. Using multivariate analysis, year of transplant < 2004 ( YOT) ( P = 0.005) was associated with higher NRM, YOT < 2004 ( P = 0.04) and SPM at allo- SCT ( P = 0.02) with lower EFS, and YOT < 2004 ( P = 0.03) and SPM at allo- SCT ( P = 0.04) with poorer OS. Conclusions Allogeneic stem cell transplantation is a valid treatment option for patients with CMML, and its outcome has improved with YOT > 2004. Splenomegaly seems to be a negative factor of OS and EFS in this series.
- Subjects
STEM cell transplantation; CHRONIC leukemia; KARYOTYPES; GRAFT versus host disease; DISEASE relapse; PROGNOSIS
- Publication
European Journal of Haematology, 2013, Vol 90, Issue 5, p355
- ISSN
0902-4441
- Publication type
Article
- DOI
10.1111/ejh.12073