Secondary acute myeloid leukemia and myelodysplasia after autologous peripheral blood progenitor cell transplantation

• Published in: Annals of hematology 2002, Vol.81 (1), p.11-15
• Main Authors: SEVILLA, J, RODRIGUEZ, A, HERNANDEZ-MARAVER, D, DE BUSTOS, J. G, AGUADO, M. J, OJEDA, E, ARRIETA, R, HERNANDEZ-NAVARRO, F
• Format: Article
• Language: English
• Subjects: Acute Disease; Adult; Biological and medical sciences; Hematologic and hematopoietic diseases; Hematopoietic Stem Cell Transplantation - adverse effects; Hodgkin Disease - pathology; Hodgkin Disease - therapy; Humans; Leukemia, Myeloid - etiology; Leukemia, Myeloid - pathology; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Lymphoma, Non-Hodgkin - pathology; Lymphoma, Non-Hodgkin - therapy; Medical sciences; Middle Aged; Multiple Myeloma - pathology; Multiple Myeloma - therapy; Myelodysplastic Syndromes - etiology; Myelodysplastic Syndromes - pathology; Neoplasms, Second Primary; Transplantation, Autologous
• ISSN: 0939-5555; 1432-0584
• DOI: 10.1007/s00277-001-0400-0

Secondary myelodysplastic syndrome (MDS) and acute leukemia (AL) are well-known complications of antineoplastic therapy. The incidence of these serious complications after autologous hematopoietic transplantation ranges from 1.1% to 24%. Prior chemotherapy is its most likely cause, but other variables related to these long-term complications are seriously discussed. There is evidence that priming of progenitor cells isolated from peripheral blood with chemotherapy is also related to a higher risk of secondary MDS/AL. Whether progenitor cells isolated from bone marrow or peripheral blood after mobilization only with cytokines are related to higher risk is a controversial issue. In this paper, we analyze the incidence and variables related to these complications in a series of 99 patients diagnosed with lymphoma or multiple myeloma who underwent autologous transplantation using hematopoietic progenitors isolated from peripheral blood mobilized with granulocyte colony-stimulating factor (G-CSF). The probability of MDS/AL in patients alive 5 years after transplant in our series is 8.58%, similar to that reported in other series using bone marrow grafts. The total dose of cyclophosphamide ( p=0.099), the number of chemotherapy cycles ( p=0.04) received before transplant, and the total dose of mononuclear cells infused at the time of transplant were the only variables associated with secondary MDS/AL. Autologous transplantation with progenitor cells isolated from peripheral blood after mobilization with cytokines has probability and risk factors for secondary MDS/AL development similar to bone marrow grafts when compared with other published series.