Bone marrow transplantation for therapy-related myelodysplasia: comparison with primary myelodysplasia
Adolescent; Adult; Antineoplastic Combined Chemotherapy Protocols; use; *Bone Marrow Transplantation; Combined Modality Therapy; Disease-Free Survival; Female; Graft vs Host Disease; Humans; Immunosuppressive Agents; Male; Methotrexate; Middle Aged; Myelodysplastic Syndromes; Treatment Outcome
Life Sciences | Medicine and Health Sciences
Therapy-related myelodysplasia (MDS) is a fatal marrow disorder distinct from primary MDS. We examined the efficacy of bone marrow transplantation (BMT) as a treatment for patients with therapy-related MDS. Eighteen patients with therapy-related MDS and twenty-five patients with primary MDS received an allogeneic, syngeneic, or unrelated donor BMT. Graft-versus-host disease prophylaxis included methotrexate, methotrexate plus cyclosporine, FK-506, or T cell depletion. Conditioning regimens consisted of cyclophosphamide/total body irradiation, with and without cytosine arabinoside, busulfan/cyclophosphamide, and cyclophosphamide/etoposide/carmustine. For patients with therapy-related MDS, the median age was 32 years and the actuarial disease-free survival was 24% (95% confidence interval 6, 42%) with a median follow-up of 3 years. For patients with primary MDS, the median age was 36 years and the actuarial disease-free survival at 3 years was 43% (95% confidence interval 22, 64%). Four of the therapy-related patients and two of the primary patients have relapsed. Three patients experienced graft failure; all three had received T cell-depleted marrow and two had marrow fibrosis. Our results suggest that patients with therapy-related MDS can be successfully transplanted. Transplantation should be considered early in the disease, since long-term disease-free survival is achievable.
DOI of Published Version
Bone Marrow Transplant. 1997 Nov;20(9):737-43. Link to article on publisher's site
Bone marrow transplantation
Ballen, Karen K.; Gilliland, D. Gary; Guinan, Eva C.; Hsieh, Chung-Cheng; Parsons, Susan K.; Rimm, Ilonna J.; Ferrara, James L. M.; Bierer, Barbara E.; Weinstein, Howard J.; and Antin, Joseph H., "Bone marrow transplantation for therapy-related myelodysplasia: comparison with primary myelodysplasia" (1998). Open Access Articles. 322.