Bone marrow transplantation for therapy-related myelodysplasia: comparison with primary myelodysplasia
Authors
Ballen, Karen K.Gilliland, D. Gary
Guinan, Eva C.
Hsieh, Chung-Cheng
Parsons, Susan K.
Rimm, Ilonna J.
Ferrara, James L. M.
Bierer, Barbara E.
Weinstein, Howard J.
Antin, Joseph H.
UMass Chan Affiliations
Cancer CenterDocument Type
Journal ArticlePublication Date
1998-01-07Keywords
AdolescentAdult
Antineoplastic Combined Chemotherapy Protocols
use
*Bone Marrow Transplantation
Combined Modality Therapy
Disease-Free Survival
Female
Graft vs Host Disease
Humans
Immunosuppressive Agents
Male
Methotrexate
Middle Aged
Myelodysplastic Syndromes
Treatment Outcome
Life Sciences
Medicine and Health Sciences
Metadata
Show full item recordAbstract
Therapy-related myelodysplasia (MDS) is a fatal marrow disorder distinct from primary MDS. We examined the efficacy of bone marrow transplantation (BMT) as a treatment for patients with therapy-related MDS. Eighteen patients with therapy-related MDS and twenty-five patients with primary MDS received an allogeneic, syngeneic, or unrelated donor BMT. Graft-versus-host disease prophylaxis included methotrexate, methotrexate plus cyclosporine, FK-506, or T cell depletion. Conditioning regimens consisted of cyclophosphamide/total body irradiation, with and without cytosine arabinoside, busulfan/cyclophosphamide, and cyclophosphamide/etoposide/carmustine. For patients with therapy-related MDS, the median age was 32 years and the actuarial disease-free survival was 24% (95% confidence interval 6, 42%) with a median follow-up of 3 years. For patients with primary MDS, the median age was 36 years and the actuarial disease-free survival at 3 years was 43% (95% confidence interval 22, 64%). Four of the therapy-related patients and two of the primary patients have relapsed. Three patients experienced graft failure; all three had received T cell-depleted marrow and two had marrow fibrosis. Our results suggest that patients with therapy-related MDS can be successfully transplanted. Transplantation should be considered early in the disease, since long-term disease-free survival is achievable.Source
Bone Marrow Transplant. 1997 Nov;20(9):737-43. Link to article on publisher's siteDOI
10.1038/sj.bmt.1700971Permanent Link to this Item
http://hdl.handle.net/20.500.14038/40413PubMed ID
9384475Related Resources
Link to article in PubMedae974a485f413a2113503eed53cd6c53
10.1038/sj.bmt.1700971