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Allogeneic stem cell transplantation for chronic myelomonocytic leukemia: a report from the Societe Francaise de Greffe de Moelle et de Therapie Cellulaire.
- Source :
- European Journal of Haematology; May2013, Vol. 90 Issue 5, p355-364, 10p, 5 Charts, 2 Graphs
- Publication Year :
- 2013
-
Abstract
- Objectives and methods Chronic myelomonocytic leukemia ( CMML) is a severe disease for which allogeneic stem cell transplantation (allo- SCT) remains the only potentially curative treatment. We describe a retrospective study determining prognostic factors for outcome after allo- SCT in consecutive 73 patients with CMML reported to the SFGM- TC registry between 1992 and 2009. Results At diagnosis, median age was 53 yrs, and 36% patients had palpable splenomegaly (SPM). 48, 13, and 9 patients had good, intermediate, and poor risk karyotype, respectively, according to IPSS, 61% patients had CMML-1, and 39% had CMML-2. 41/31/1 cases had an HLA-identical sibling, an unrelated and haploidentical donor, respectively. 43 patients received reduced-intensity conditioning. With a median follow-up of 23 month, acute grade 2-4 and chronic GVHD developed in 21 and 25 patients, respectively. The 3-year OS, NRM (non-relapse mortality), EFS, and CIR (cumulative incidence of relapse) were 32%, 36%, 29% and 35%, respectively. OS was not influenced by the CR status, marrow blasts% at allo-SCT, prior treatments, and cGVHD. Using multivariate analysis, year of transplant < 2004 ( YOT) ( P = 0.005) was associated with higher NRM, YOT < 2004 ( P = 0.04) and SPM at allo- SCT ( P = 0.02) with lower EFS, and YOT < 2004 ( P = 0.03) and SPM at allo- SCT ( P = 0.04) with poorer OS. Conclusions Allogeneic stem cell transplantation is a valid treatment option for patients with CMML, and its outcome has improved with YOT > 2004. Splenomegaly seems to be a negative factor of OS and EFS in this series. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 09024441
- Volume :
- 90
- Issue :
- 5
- Database :
- Complementary Index
- Journal :
- European Journal of Haematology
- Publication Type :
- Academic Journal
- Accession number :
- 87016459
- Full Text :
- https://doi.org/10.1111/ejh.12073