Role of allogeneic transplantation in chronic myelomonocytic leukemia : an international collaborative analysis
© 2022 by The American Society of Hematology..
To determine the survival benefit of allogeneic hematopoietic cell transplantation (allo-HCT) in chronic myelomonocytic leukemias (CMML), we assembled a retrospective cohort of CMML patients 18-70 years old diagnosed between 2000 and 2014 from an international CMML dataset (n = 730) and the EBMT registry (n = 384). The prognostic impact of allo-HCT was analyzed through univariable and multivariable time-dependent models and with a multistate model, accounting for age, sex, CMML prognostic scoring system (low or intermediate-1 grouped as lower-risk, intermediate-2 or high as higher-risk) at diagnosis, and AML transformation. In univariable analysis, lower-risk CMMLs had a 5-year overall survival (OS) of 20% with allo-HCT vs 42% without allo-HCT (P < .001). In higher-risk patients, 5-year OS was 27% with allo-HCT vs 15% without allo-HCT (P = .13). With multistate models, performing allo-HCT before AML transformation reduced OS in patients with lower-risk CMML, and a survival benefit was predicted for men with higher-risk CMML. In a multivariable analysis of lower-risk patients, performing allo-HCT before transformation to AML significantly increased the risk of death within 2 years of transplantation (hazard ratio [HR], 3.19; P < .001), with no significant change in long-term survival beyond this time point (HR, 0.98; P = .92). In higher-risk patients, allo-HCT significantly increased the risk of death in the first 2 years after transplant (HR 1.46; P = .01) but not beyond (HR, 0.60; P = .09). Performing allo-HCT before AML transformation decreases life expectancy in lower-risk patients but may be considered in higher-risk patients.
| Errataetall: |
ErratumIn: Blood. 2023 Jun 29;141(26):3232-3233. - PMID 37383000 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:140 |
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| Enthalten in: |
Blood - 140(2022), 12 vom: 22. Sept., Seite 1408-1418 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Robin, Marie [VerfasserIn] |
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| Anmerkungen: |
Date Completed 26.09.2022 Date Revised 08.01.2024 published: Print ErratumIn: Blood. 2023 Jun 29;141(26):3232-3233. - PMID 37383000 Citation Status MEDLINE |
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| doi: |
10.1182/blood.2021015173 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM341889067 |
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| 500 | |a ErratumIn: Blood. 2023 Jun 29;141(26):3232-3233. - PMID 37383000 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2022 by The American Society of Hematology. | ||
| 520 | |a To determine the survival benefit of allogeneic hematopoietic cell transplantation (allo-HCT) in chronic myelomonocytic leukemias (CMML), we assembled a retrospective cohort of CMML patients 18-70 years old diagnosed between 2000 and 2014 from an international CMML dataset (n = 730) and the EBMT registry (n = 384). The prognostic impact of allo-HCT was analyzed through univariable and multivariable time-dependent models and with a multistate model, accounting for age, sex, CMML prognostic scoring system (low or intermediate-1 grouped as lower-risk, intermediate-2 or high as higher-risk) at diagnosis, and AML transformation. In univariable analysis, lower-risk CMMLs had a 5-year overall survival (OS) of 20% with allo-HCT vs 42% without allo-HCT (P < .001). In higher-risk patients, 5-year OS was 27% with allo-HCT vs 15% without allo-HCT (P = .13). With multistate models, performing allo-HCT before AML transformation reduced OS in patients with lower-risk CMML, and a survival benefit was predicted for men with higher-risk CMML. In a multivariable analysis of lower-risk patients, performing allo-HCT before transformation to AML significantly increased the risk of death within 2 years of transplantation (hazard ratio [HR], 3.19; P < .001), with no significant change in long-term survival beyond this time point (HR, 0.98; P = .92). In higher-risk patients, allo-HCT significantly increased the risk of death in the first 2 years after transplant (HR 1.46; P = .01) but not beyond (HR, 0.60; P = .09). Performing allo-HCT before AML transformation decreases life expectancy in lower-risk patients but may be considered in higher-risk patients | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a de Wreede, Liesbeth C |e verfasserin |4 aut | |
| 700 | 1 | |a Padron, Eric |e verfasserin |4 aut | |
| 700 | 1 | |a Bakunina, Katerina |e verfasserin |4 aut | |
| 700 | 1 | |a Fenaux, Pierre |e verfasserin |4 aut | |
| 700 | 1 | |a Koster, Linda |e verfasserin |4 aut | |
| 700 | 1 | |a Nazha, Aziz |e verfasserin |4 aut | |
| 700 | 1 | |a Beelen, Dietrich W |e verfasserin |4 aut | |
| 700 | 1 | |a Rampal, Raajit K |e verfasserin |4 aut | |
| 700 | 1 | |a Sockel, Katja |e verfasserin |4 aut | |
| 700 | 1 | |a Komrokji, Rami S |e verfasserin |4 aut | |
| 700 | 1 | |a Gagelmann, Nico |e verfasserin |4 aut | |
| 700 | 1 | |a Eikema, Dirk-Jan |e verfasserin |4 aut | |
| 700 | 1 | |a Radujkovic, Aleksandar |e verfasserin |4 aut | |
| 700 | 1 | |a Finke, Jürgen |e verfasserin |4 aut | |
| 700 | 1 | |a Potter, Victoria |e verfasserin |4 aut | |
| 700 | 1 | |a Killick, Sally B |e verfasserin |4 aut | |
| 700 | 1 | |a Legrand, Faezeh |e verfasserin |4 aut | |
| 700 | 1 | |a Solary, Eric |e verfasserin |4 aut | |
| 700 | 1 | |a Broom, Angus |e verfasserin |4 aut | |
| 700 | 1 | |a Garcia-Manero, Guillermo |e verfasserin |4 aut | |
| 700 | 1 | |a Rizzoli, Vittorio |e verfasserin |4 aut | |
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| 700 | 1 | |a Patnaik, Mrinal M |e verfasserin |4 aut | |
| 700 | 1 | |a Onida, Francesco |e verfasserin |4 aut | |
| 700 | 1 | |a Yakoub-Agha, Ibrahim |e verfasserin |4 aut | |
| 700 | 1 | |a Itzykson, Raphael |e verfasserin |4 aut | |
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