Myelodysplasia and acute myeloid leukemia occurring after autologous bone marrow transplantation for lymphoma

Abstract

Secondary hematopoietic disease manifesting as acute myeloid leukemia, myelodysplastic syndrome or clonal karyotypic abnormalities, has been recently recognized as a relatively frequent and potentially serious complication of autologous bone marrow transplantation for both Hodgkin's disease and non-Hodgkin's lymphoma. The available evidence suggests the disease results primarily from repeated exposure of the host stem cells to therapeutic agents before the time of transplant, but a conspiratory role for the transplantation procedure itself cannot be entirely excluded. Strategies to decrease the incidence of secondary hematopoietic disease include earlier stem cell harvest and/or transplantation, and the performance of screening karyotypic studies on the bone marrow prior to autologous grafting.

Long-term haematological recovery following high-dose chemotherapy with autologous bone marrow transplantation or peripheral stem cell transplantation in patients with solid tumours

“…[40][41][42][43][44][45][46] It is suggested that prolonged dysfunction of the haematopoietic system leads to the emergence of these secondary diseases, 43,47 typically occurring between 2 and 10 years after chemotherapy with the peak incidence after 5 years. Incidences up to 19.8% at 10 years have been reported following transplantation for non-Hodgkin's lymphoma.…”

Primary myelodysplasia occurring in adults under 50 years old: a clinicopathologic study of 52 patients

“…MDS may occur as a consequence of marrow injury caused by chemotherapeutic agents or radiation used to treat prior benign or malignant conditions. [3][4][5][6][7] More commonly, MDS may occur as a primary disorder, in which no ascertainable cause for the disease can be identified. Even in the absence of leukemic evolution, most patients with MDS succumb to infection or transfusion-related complications, such as platelet alloimmunization or iron overload.…”

High risk of therapy-related leukemia after BEAM chemotherapy and autologous stem cell transplantation for previously treated lymphomas is mainly related to primary chemotherapy and not to the BEAM–transplantation procedure

“…[4][5][6][7][8][9] From our institution we have previously (ASCT) and was followed for relapse and development of leu- followed by ASCT for malignant lymphomas, in most cases During the period January 1991 to July 1995 a total of 27 t-MDS and t-AML rather than the BEAM and ASCT regimen, which however may accelerate the evolution of the disease.patients with Hodgkin's disease and 49 patients with nonKeywords: therapy-related leukemia; secondary leukemia; maligHodgkin lymphomas received high-dose chemotherapy with nant lymphomas; BEAM chemotherapy; autologous stem cell trans-BEAM followed by ASCT in our department. BEAM consisted plantation of carmustine 300 mg/m 2 day 1 followed by etoposide 100 mg/m 2 twice a day plus cytosine-arabinoside 400 mg/m 2 daily for 4 days followed by melphalan 140 mg/m 2 on day 6.…”

“…[4][5][6][7][8][9] From our institution we have previously (ASCT) and was followed for relapse and development of leu- followed by ASCT for malignant lymphomas, in most cases During the period January 1991 to July 1995 a total of 27 t-MDS and t-AML rather than the BEAM and ASCT regimen, which however may accelerate the evolution of the disease.…”