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Blood, 1 January 2008, Vol. 111, No. 1, pp. 94-100. Prepublished online as a Blood First Edition Paper on September 25, 2007; DOI 10.1182/blood-2007-06-097444. This Article Full Text Full Text (PDF) All Versions of this Article: blood-2007-06-097444v1 111/1/94    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Barlogie, B. Articles by Sawyer, J. Search for Related Content PubMed PubMed Citation Articles by Barlogie, B. Articles by Sawyer, J. Related Collections Neoplasia Transplantation Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS Cytogenetically defined myelodysplasia after melphalan-based autotransplantation for multiple myeloma linked to poor hematopoietic stem-cell mobilization: the Arkansas experience in more than 3000 patients treated since 1989 Bart Barlogie1, Guido Tricot1, Jeff Haessler2, Frits van Rhee1, Michele Cottler-Fox1,3, Elias Anaissie1, James Waldron3, Mauricio Pineda-Roman1, Raymond Thertulien1, Maurizio Zangari1, Klaus Hollmig1, Abid Mohiuddin1, Yazan Alsayed1, Antje Hoering2, John Crowley2, and Jeffrey Sawyer1,3 1 Myeloma Institute for Research and Therapy, University of Arkansas for Medical Sciences, Little Rock; 2 Cancer Research and Biostatistics, Seattle, WA; and 3 Department of Pathology, University of Arkansas for Medical Sciences, Little Rock Myelodysplastic syndrome (MDS) is a well-recognized complication of chemotherapy for multiple myeloma (MM). Serial bone marrow metaphase examinations were performed for MM restaging in 3077 patients undergoing high-dose therapy (HDT). MDS-associated cytogenetic abnormalities (MDS-CAs) were observed in 105 of 2418 patients in whom cytogenetic data were available after HDT. MDS-CAs occurred transiently in 72 patients and on 3 successive occasions (persistent MDS-CAs) in 33 patients, for 10-year estimates of 4% and 2%, respectively; only 21 patients developed overt clinical MDS and 5, acute myeloblastic leukemia (AML). MDS-CA development was linked to lower CD34 yield at collection, longer time interval from MM diagnosis to HDT, older age, and lower platelet recovery after HDT; persistent MDS-CAs were predicted by CD34 yield of less than 3 x 106/kg and need for more than 2 apheresis procedures. Applying a tertile frequency distribution over time to all 105 patients with MDS-CAs, its detection early after HDT was associated with longer time interval from diagnosis and low pre-HDT platelet count (likely resulting from pre-HDT damage), whereas late-onset MDS-CAs were noted among patients treated with Total Therapy 2 and Total Therapy 3 that applied post-HDT consolidation chemotherapy (suggesting possible post-HDT damage). While the risk of MDS-CAs was low and clinical MDS occurred infrequently, monitoring after post-HDT consolidation chemotherapy appears warranted. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: M. A. Lichtman Is There an Entity of Chemically Induced BCR-ABL-Positive Chronic Myelogenous Leukemia? Oncologist, June 1, 2008; 13(6): 645 - 654. [Abstract] [Full Text] [PDF]

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