Tamila L. Kindwall-Keller, Uday R. Popat, Jaroslaw P. Maciejewski, Bronwen E. Shaw, Robert J. Hayashi, Remco J. Molenaar, Navneet S. Majhail, David I. Marks, Robert F. Cornell, Adriana K. Malone, Richard F. Olsson, Ruta Brazauskas, Jean-Yves Cahn, Basem M. William, Nandita Khera, Joseph W. Fay, Amer Beitinjaneh, Ibrahim Ahmed, Amir Steinberg, Heather Landau, Yoshihiro Inamoto, Peiman Hematti, Heather B. Allewelt, Anne B. Warwick, Kimberly A. Kasow, Mary E.D. Flowers, Harry C. Schouten, Anita D'Souza, Jennifer Holter Chakrabarty, Minoo Battiwalla, Tomas Radivoyevitch, Robert M. Dean, Baldeep Wirk, Gorgun Akpek, Siddhartha Ganguly, Shahrukh K. Hashmi, Sonata Jodele, J. Douglas Rizzo, Matt Kalaycio, Zachariah DeFilipp, Robert Peter Gale, William A. Wood, Hillard M. Lazarus, Andrew Daly, Kenneth R. Cooke, Anuj Mahindra, Muneer H. Abidi, Heather R. Tecca, Sachiko Seo, Ashish Bajel, Betty K. Hamilton, Mahmoud Aljurf, David Buchbinder, Rachel J. Cook, Mark R. Litzow, Jean A. Yared, Gregory A. Hale, Bipin N. Savani, Mikkael A. Sekeres, Mehdi Hamadani, Medical Biology, Graduate School, Cell Biology and Histology, and CCA - Cancer Treatment and Quality of Life
Background Exposures to DNA-damaging drugs and ionizing radiations increase risks of acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS). Methods 9028 recipients of hematopoietic cell autotransplants (1995–2010) for Hodgkin lymphoma (HL; n = 916), non-Hodgkin lymphoma (NHL; n = 3546) and plasma cell myeloma (PCM; n = 4566), reported to the CIBMTR, were analyzed for risk of subsequent AML or MDS. Results 335 MDS/AML cases were diagnosed posttransplant (3.7%). Variables associated with an increased risk for AML or MDS in multivariate analyses were: (1) conditioning with total body radiation versus chemotherapy alone for HL (HR = 4.0; 95% confidence interval [1.4, 11.6]) and NHL (HR = 2.5 [1.1, 2.5]); (2) ≥3 versus 1 line of chemotherapy for NHL (HR = 1.9 [1.3, 2.8]); and (3) subjects with NHL transplanted in 2005–2010 versus 1995–1999 (HR = 2.1 [1.5, 3.1]). Using Surveillance, Epidemiology and End Results (SEER) data, we found risks for AML/MDS in HL, NHL and PCM to be 5–10 times the background rate. In contrast, relative risks were 10–50 for AML and approximately 100 for MDS in the autotransplant cohort. Conclusions There are substantial risks of AML and MDS after autotransplants for HL, NHL and PCM.