11 research outputs found
The outcomes of secondary AML post allogeneic hematopoietic cell transplantation significantly depend on the presence of poorârisk cytogenetic abnormalities
Abstract Secondary acute myeloid leukemia (sAML) includes AML as a complication of an antecedent hematological disorder or a therapyârelated AML. Large registryâbased data identified sAML as an independent poorâoutcome type of AML post allogeneic hematopoietic cell transplantation (alloâHCT). In our study, we tried to define factors affecting outcomes of sAML post alloâHCT, and identify patients with sAML who may truly benefit from alloâHCT. We retrospectively analyzed the data of 64 patients aged (14â61 years) with sAML who received alloâHCT between September 2010 and February 2018 at our institute. Most of the patients were transplanted from matched related donors (MRD; 54, 84.4%). Our results showed that poorârisk cytogenetics were identified in 31 patients (48.4%), and their presence was an indicator of poor overall survival (OS) and diseaseâfree survival (DFS; Pâvalue = .009, and .004, respectively). The cumulative incidence of chronic graftâversusâhost disease (cGVHD) was significantly lower in sAML patients with poorârisk cytogenetics (Pâvalue = .003) resulting in a high risk of death without cGVHD in this group of patients (Pâvalue = .02). Besides, GVHD relapseâfree survival (GRFS) analysis showed that most of our studied patients experienced either relapse or debilitating grade IIâIV cGVHD in the first 2 years post alloâHCT. We conclude that sAML patients with poorârisk cytogenetics have a significantly lower DFS post alloâHCT with a high risk of death without active cGVHD
Risk factors and outcomes according to age at transplantation with an HLA-identical sibling for sickle cell disease.
Allogeneic hematopoietic stem cell transplantation (HSCT) remains the only curative therapy for sickle cell disease (SCD).41 Several barriers prevent its widespread application, including the lack of a suitable donor, risk of early and late onset of regimen-related toxicities, rejection and mortality. Despite these limitations, the number of transplants for hemoglobinopathies has been increasing in the last decade. The overall probability of survival (OS) for patients with SCD transplanted with a human lymphocyte antigen (HLA)- identical sibling graft ranges between 91 and 100% with an event-free survival (EFS) of 73-100%.3 A controversial issue is the ideal age to perform HSCT in SCD patients. In fact, whilst early age HSCT could prevent SCD-related organ damage, resulting in better patient outcomes, the emergence of new available SCD supportive care, promising curative therapies could justify not proceeding with HSCT in certain cases [...