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Blood, 15 August 2007, Vol. 110, No. 4, pp. 1379-1387. Prepublished online as a Blood First Edition Paper on May 8, 2007; DOI 10.1182/blood-2007-02-076307. This Article Full Text (PDF) All Versions of this Article: blood-2007-02-076307v1 110/4/1379    most recent Alert me when this article is cited Alert me if a correction is posted 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 CrossRef Citing Articles via Google Scholar Google Scholar Articles by Chang, C. Articles by Deeg, H J. Search for Related Content PubMed PubMed Citation Articles by Chang, C. Articles by Deeg, H J. Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted February 26, 2007 Accepted April 24, 2007 Hematopoietic cell transplantation in patients with myelodysplastic syndrome or acute myeloid leukemia arising from myelodysplastic syndrome: similar outcomes in patients with de novo disease and disease following prior therapy or antecedent hematologic disorders ChunKang Chang, Barry E Storer, Bart L Scott, Eileen M Bryant, Howard M Shulman, Mary E Flowers, Brenda M Sandmaier, Robert P Witherspoon, Richard A. Nash, Jean E Sanders, Antonio Bedalov, John A Hansen, Bruce E Clurman, Rainer Storb, Frederick R. Appelbaum, and H Joachim Deeg* Department of Hematology, Shanghai Sixth People's Hospital, Shanghai JiaoTong University, Shanghai, China Clinical Research Division, Fred Hutchinson Cancer Research Center and the University of Washington School of Medicine, Seattle, WA, United States University of Washington, Seattle, WA, United States * Corresponding author; email: jdeeg{at}fhcrc.org. We analyzed outcomes after hematopoietic cell transplantation (HCT) in 257 patients, 3-72.7 (median, 43) years old, with secondary myelodysplastic syndrome (MDS) including those with transformation to acute myeloid leukemia (tAML). Conditioning regimens included high-dose total-body irradiation (TBI)/chemotherapy (n=83); busulfan (BU)/cyclophosphamide (CY) (BUCY) (n=122) (with BU targeting [tBUCY] in 93 patients); fludarabine (Flu) with tBU (FLUtBU) in 12, Flu plus 200 cGy TBI in 26, and miscellaneous regimens in 14 patients. Donors were HLA-identical or partially mismatched family members in 135, and unrelated individuals in 122 patients. Five-year relapse-free survival was highest (43%) and non-relapse mortality lowest (28%) among tBUCY conditioned patients. Outcomes were compared to results in 339 patients transplanted for de novo MDS/tAML, and a multivariate analysis failed to show significant differences in outcome between the two cohorts. Relapse probability and relapse-free survival correlated significantly with disease stage (P < 0.0001) and karyotype (P < 0.0001). Relapse incidence was lower (P = 0.003) and relapse-free survival superior (P = 0.02) with unrelated donor transplants. The data suggest that overall inferior outcome in patients with secondary MDS/tAML was related to the frequency of high-risk cytogenetics. For both cohorts, transplant outcomes improved over the time interval studied. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

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