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

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.

• Authors: J Sevilla, A Rodríguez, D Hernández-Maraver, G de Bustos, J Aguado, E Ojeda, R Arrieta, F Hernández-Navarro
• Journal: Annals of hematology (Ann Hematol) Vol. 81 Issue 1 Pg. 11-5 (Jan 2002) ISSN: 0939-5555 [Print] Germany
• PMID: 11807629 (Publication Type: Journal Article)

Topics

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