Characteristics and outcomes of therapy-related acute leukemia following autologous transplant (Auto-HCT) for multiple myeloma.

IF 4.5 2区 医学 Q1 HEMATOLOGY Bone Marrow Transplantation Pub Date : 2024-10-30 DOI:10.1038/s41409-024-02455-4
Omar Elghawy, Saarang Deshpande, Jonathan Sussman, Alfred Garfall, Adam Cohen, Shivani Kapur, Sandra Susanibar-Adaniya, Dan Vogl, Adam Waxman, Edward Stadtmauer
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Abstract

With a prolonging duration of survivorship, patients with multiple myeloma (MM) who receive high-dose chemotherapy and autologous hematopoietic stem cell transplantation (auto-HCT) have an increased risk of secondary malignancy, most concerning acute leukemia. We retrospectively reviewed the records of all patients with MM who underwent auto-HCT between January 1, 2010, and January 1, 2023, who later developed therapy-related acute leukemia (t-AL). Of 1770 patients with MM who underwent auto-HCT, 18 (1.01%) developed t-AL at a mean interval of 60.0 ± 41.3 months after auto-HCT. The patients with t-AL consisted of 9 (50%) with B-cell acute lymphoblastic leukemia (B-ALL), 8 (44.4%) with acute myeloid leukemia (AML), and 1 (5.6%) with acute promyelocytic leukemia (APML). All patients had received an alkylating agent as part of induction, and the majority received lenalidomide as maintenance therapy. Genetic abnormalities of t-AL were consistent with prior reports. Median overall survival from diagnosis of t-AL was 19.5 months. In patients with t-AL who entered CR, long term survival was common. Further research on predisposing conditions to developing t-AL in patients with MM undergoing auto-HCT is warranted.

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多发性骨髓瘤自体移植(Auto-HCT)后与治疗相关的急性白血病的特征和预后。
随着存活时间的延长,接受大剂量化疗和自体造血干细胞移植(auto-HCT)的多发性骨髓瘤(MM)患者罹患继发性恶性肿瘤(最常见的是急性白血病)的风险也在增加。我们回顾性研究了2010年1月1日至2023年1月1日期间接受自体造血干细胞移植的所有MM患者的病历,这些患者后来都患上了与治疗相关的急性白血病(t-AL)。在1770名接受了自体血细胞移植的MM患者中,有18人(1.01%)在自体血细胞移植后平均间隔60.0±41.3个月时患上了t-AL。t-AL患者包括9名(50%)B细胞急性淋巴细胞白血病(B-ALL)患者、8名(44.4%)急性髓细胞白血病(AML)患者和1名(5.6%)急性早幼粒细胞白血病(APML)患者。所有患者在诱导治疗中都使用了烷化剂,大多数患者在维持治疗中使用了来那度胺。t-AL的基因异常与之前的报告一致。t-AL确诊后的中位总生存期为19.5个月。在进入CR的t-AL患者中,长期存活率很高。对于接受自体血细胞移植的 MM 患者易患 t-AL 的情况,有必要进行进一步研究。
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来源期刊
Bone Marrow Transplantation
Bone Marrow Transplantation 医学-免疫学
CiteScore
8.40
自引率
8.30%
发文量
337
审稿时长
6 months
期刊介绍: Bone Marrow Transplantation publishes high quality, peer reviewed original research that addresses all aspects of basic biology and clinical use of haemopoietic stem cell transplantation. The broad scope of the journal thus encompasses topics such as stem cell biology, e.g., kinetics and cytokine control, transplantation immunology e.g., HLA and matching techniques, translational research, and clinical results of specific transplant protocols. Bone Marrow Transplantation publishes 24 issues a year.
期刊最新文献
Measurable residual disease testing and allogeneic hematopoietic cell transplantation for AML: adapting Pre-MEASURE to clinical practice. High-dose chemotherapy with autologous haematopoietic stem cell transplantation in patients with isolated vitreoretinal lymphoma: a LOC network study. Immunological reconstitution and infections after alloHCT - a comparison between post-transplantation cyclophosphamide, ATLG and non-ATLG based GvHD prophylaxis. Belumosudil combination therapy for chronic graft-versus-host-disease in real-world clinical practice. Successful allogeneic CD34+ hematopoietic stem cell boost for prolonged cytopenias following CAR T-cell therapy in B-cell acute lymphoblastic leukemia. On behalf of the Spanish Group for Hematopoietic Transplantation and Cellular Therapy (GETH-TC).
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