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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 (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 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. Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted June 22, 2007 Accepted September 10, 2007 Cytogenetically defined myelodysplasia after melphalan-based autotranplants for multiple myeloma linked to poor hematopoietic stem cell mobilization: the Arkansas experience in more than 3000 patients treated since 1989 Bart Barlogie*, Guido Tricot, Jeff Haessler, Frits van Rhee, Michele Cottler-Fox, Elias Anaissie, James Waldron, Mauricio Pineda-Roman, Raymond Thertulien, Maurizio Zangari, Klaus Hollmig, Abid Mohiuddin, Yazan Alsayed, Antje Hoering, John Crowley, and Jeffrey Sawyer Myeloma Institute for Research and Therapy, University of Arkansas for Medical Sciences, Little Rock, AR Cancer Research and Biostatistics, Seattle, WA Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR * Corresponding author; email: barlogiebart{at}uams.edu. Myelodysplasia (MDS) is a well recognized complication of chemotherapy for multiple myeloma (MM). Serial bone marrow metaphase examinations were performed for MM re-staging in 3077 patients undergoing high-dose therapy (HDT). MDS-associated cytogenetic abnormalities (MDS-CA) were observed in 105 of 2418 patients in whom cytogenetic data were available post-HDT. MDS-CA occurred transiently in 72 and on 3 successive occasions (persistent MDS-CA) in 33 patients, for 10-yr estimates of 4% and 2%; only 21 patients developed overt clinical MDS and 5 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 post-HDT; persistent MDS-CA was predicted by CD34 yield <3x106/kg and need for more than 2 apheresis procedures. Applying a tertile frequency distribution over time to all 105 patients with MDS-CA, its detection early post-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-CA was 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-CA 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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