Secondary acute myeloid leukemia and myelodysplasia after autologous peripheral blood progenitor cell transplantation

Ann Hematol. 2002 Jan;81(1):11-5. doi: 10.1007/s00277-001-0400-0. Epub 2001 Dec 8.

Abstract

Secondary myelodysplastic syndrome (MDS) and acute leukemia (AL) are well-known complications of antineoplastic therapy. The incidence of these serious complications after autologous hematopoietic transplantation ranges from 1.1% to 24%. Prior chemotherapy is its most likely cause, but other variables related to these long-term complications are seriously discussed. There is evidence that priming of progenitor cells isolated from peripheral blood with chemotherapy is also related to a higher risk of secondary MDS/AL. Whether progenitor cells isolated from bone marrow or peripheral blood after mobilization only with cytokines are related to higher risk is a controversial issue. In this paper, we analyze the incidence and variables related to these complications in a series of 99 patients diagnosed with lymphoma or multiple myeloma who underwent autologous transplantation using hematopoietic progenitors isolated from peripheral blood mobilized with granulocyte colony-stimulating factor (G-CSF). The probability of MDS/AL in patients alive 5 years after transplant in our series is 8.58%, similar to that reported in other series using bone marrow grafts. The total dose of cyclophosphamide ( p=0.099), the number of chemotherapy cycles ( p=0.04) received before transplant, and the total dose of mononuclear cells infused at the time of transplant were the only variables associated with secondary MDS/AL. Autologous transplantation with progenitor cells isolated from peripheral blood after mobilization with cytokines has probability and risk factors for secondary MDS/AL development similar to bone marrow grafts when compared with other published series.

MeSH terms

  • Acute Disease
  • Adult
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Hodgkin Disease / pathology
  • Hodgkin Disease / therapy*
  • Humans
  • Leukemia, Myeloid / etiology*
  • Leukemia, Myeloid / pathology
  • Lymphoma, Non-Hodgkin / pathology
  • Lymphoma, Non-Hodgkin / therapy*
  • Middle Aged
  • Multiple Myeloma / pathology
  • Multiple Myeloma / therapy*
  • Myelodysplastic Syndromes / etiology*
  • Myelodysplastic Syndromes / pathology
  • Neoplasms, Second Primary*
  • Transplantation, Autologous