Allogeneic stem cell transplantation in patients with atypical chronic myeloid leukaemia: a retrospective study from the Chronic Malignancies Working Party of the European Society for Blood and Marrow Transplantation

Onida, Francesco; De Wreede, Lliesbeth C.; van Blezan, Anja; Elkema, Diderik-Jan; Byrne, Jenny L.; Iori, Anna P.; Schots, Rick; Jungova, Alexandra; Schetelig, Johannes; Finke, Juergen; Veelken, Hendrick; Johanssen, Jan-Erik; Craddock, Charles; Stellies, Matthias; Theobald, Matthias; Holler, Ernst; Schanz, Urs; Schaap, Nicolaas; Bittenbring, Joerg; Olivaria, Eduardo; Chalandan, Yves; Kroger, Nicolaus; the Myeloproliferative Neoplasm Subcommittee of the Chronic Malignancies Working Party

Abstract

Atypical chronic myeloid leukaemia (aCML) is an aggressive malignancy for which allogeneic haematopoietic stem cell transplantation (allo-HSCT) represents the only curative option. We describe transplant outcomes in 42 patients reported to the European Society for Blood and Marrow Transplantation (EBMT) registry who underwent allo-HSCT for aCML between 1997 and 2006. Median age was 46 years. Median time from diagnosis to transplant was 7 months. Disease status was first chronic phase in 69%. Donors were human leucocyte antigen (HLA)-identical siblings in 64% and matched unrelated (MUD) in 36%. A reduced intensity conditioning was employed in 24% of patients. T-cell depletion was applied in 87% and 26% of transplants from MUD and HLA-identical siblings, respectively. According to the EBMT risk-score, 45% of patients were ‘low-risk’, 31% ‘intermediate-risk’ and 24% ‘high-risk’. Following allo-HSCT, 87% of patients achieved complete remission. At 5 years, relapse-free survival was 36% and non-relapse mortality (NRM) was 24%, while relapse occurred in 40%. Patient age and the EBMT score had an impact on overall survival. Relapse-free survival was higher in MUD than in HLA-identical sibling HSCT, with no difference in NRM. In conclusion, this study confirmed that allo-HSCT represents a valid strategy to achieve cure in a reasonable proportion of patients with aCML, with young patients with low EBMT risk score being the best candidates.

Citation

Onida, F., De Wreede, L. C., van Blezan, A., Elkema, D.-J., Byrne, J. L., Iori, A. P., Schots, R., Jungova, A., Schetelig, J., Finke, J., Veelken, H., Johanssen, J.-E., Craddock, C., Stellies, M., Theobald, M., Holler, E., Schanz, U., Schaap, N., Bittenbring, J., Olivaria, E., …the Myeloproliferative Neoplasm Subcommittee of the Chronic Malignancies Working Party. (2017). Allogeneic stem cell transplantation in patients with atypical chronic myeloid leukaemia: a retrospective study from the Chronic Malignancies Working Party of the European Society for Blood and Marrow Transplantation. British Journal of Haematology, 177(5), 759-765. https://doi.org/10.1111/bjh.14619

• Journal Article Type: Article
• Acceptance Date: Dec 31, 2016
• Online Publication Date: Mar 28, 2017
• Publication Date: 2017-06
• Deposit Date: Dec 14, 2017
• Publicly Available Date: Dec 14, 2017
• Journal: British Journal of Haematology
• Print ISSN: 0007-1048
• Electronic ISSN: 1365-2141
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 177
• Issue: 5
• Pages: 759-765
• DOI: https://doi.org/10.1111/bjh.14619
• Keywords: allogeneic transplantation, atypical chronic myeloid leukaemia, Myelodyslastic/Myeloproliferative Neoplasms (MDS/MPN), Ph-negative CML:BCR-ABL1-negative
• Public URL: https://nottingham-repository.worktribe.com/output/863277
• Publisher URL: http://onlinelibrary.wiley.com/doi/10.1111/bjh.14619/abstract
• Additional Information: This is the pre-peer reviewed version of the following article:Onida, F., de Wreede, L. C., van Biezen, A., Eikema, D.-J., Byrne, J. L., Iori, A. P., Schots, R., Jungova, A., Schetelig, J., Finke, J., Veelken, H., Johansson, J.-E., Craddock, C., Stelljes, M., Theobald, M., Holler, E., Schanz, U., Schaap, N., Bittenbring, J., Olavarria, E., Chalandon, Y., Kröger, N. and the Myeloproliferative Neoplasm Subcommittee of the Chronic Malignancies Working Party (2017), Allogeneic stem cell transplantation in patients with atypical chronic myeloid leukaemia: a retrospective study from the Chronic Malignancies Working Party of the European Society for Blood and Marrow Transplantation. Br J Haematol, 177: 759–765. doi:10.1111/bjh.14619, which has been published in final form at http://onlinelibrary.wiley.com/doi/10.1111/bjh.14619/abstract. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving
• Contract Date: Dec 14, 2017