Allogeneic Hematopoietic Cell Transplantation for Adult Chronic Myelomonocytic Leukemia.

Published

Journal Article

Allogeneic hematopoietic cell transplantation (HCT) is potentially curative for patients with chronic myelomonocytic leukemia (CMML); however, few data exist regarding prognostic factors and transplantation outcomes. We performed this retrospective study to identify prognostic factors for post-transplantation outcomes. The CMML-specific prognostic scoring system (CPSS) has been validated in subjects receiving nontransplantation therapy and was included in our study. From 2001 to 2012, 209 adult subjects who received HCT for CMML were reported to the Center for International Blood and Marrow Transplant Research. The median age at transplantation was 57 years (range, 23 to 74). Median follow-up was 51 months (range, 3 to 122). On multivariate analyses, CPSS scores, Karnofsky performance status (KPS), and graft source were significant predictors of survival (P = .004, P = .01, P = .01, respectively). Higher CPSS scores were not associated with disease-free survival, relapse, or transplantation-related mortality. In a restricted analysis of subjects with relapse after HCT, those with intermediate-2/high risk had a nearly 2-fold increased risk of death after relapse compared to those with low/intermediate-1 CPSS scores. Respective 1-year, 3-year, and 5-year survival rates for low/intermediate-1 risk subjects were 61% (95% confidence interval [CI], 52% to 72%), 48% (95% CI, 37% to 59%), and 44% (95% CI, 33% to 55%), and for intermediate-2/high risk subjects were 38% (95% CI, 28% to 49%), 32% (95% CI, 21% to 42%), and 19% (95% CI, 8% to 29%). We conclude that higher CPSS score at time of transplantation, lower KPS, and a bone marrow graft are associated with inferior survival after HCT. Further investigation of CMML disease-related biology may provide insights into other risk factors predictive of post-transplantation outcomes.

Full Text

Duke Authors

Cited Authors

  • Liu, HD; Ahn, KW; Hu, Z-H; Hamadani, M; Nishihori, T; Wirk, B; Beitinjaneh, A; Rizzieri, D; Grunwald, MR; Sabloff, M; Olsson, RF; Bajel, A; Bredeson, C; Daly, A; Inamoto, Y; Majhail, N; Saad, A; Gupta, V; Gerds, A; Malone, A; Tallman, M; Reshef, R; Marks, DI; Copelan, E; Gergis, U; Savoie, ML; Ustun, C; Litzow, MR; Cahn, J-Y; Kindwall-Keller, T; Akpek, G; Savani, BN; Aljurf, M; Rowe, JM; Wiernik, PH; Hsu, JW; Cortes, J; Kalaycio, M; Maziarz, R; Sobecks, R; Popat, U; Alyea, E; Saber, W

Published Date

  • May 2017

Published In

Volume / Issue

  • 23 / 5

Start / End Page

  • 767 - 775

PubMed ID

  • 28115276

Pubmed Central ID

  • 28115276

Electronic International Standard Serial Number (EISSN)

  • 1523-6536

Digital Object Identifier (DOI)

  • 10.1016/j.bbmt.2017.01.078

Language

  • eng

Conference Location

  • United States