Outcome and Risk Factors for Therapy-Related Myeloid Neoplasms Treated with Allogeneic Stem Cell Transplantation in Japan

Abstract This study aimed to investigate allogeneic hematopoietic cell transplantation (HCT) outcomes and risk factors in adult patients with therapy-related myeloid neoplasm (t-MN) using Japanese registry data. Between 2002 and 2012, a total 12,169 adult patients underwent HCT for acute myeloid leukemia (AML), myelodysplastic syndrome (MDS), and chronic myelomonocytic leukemia (CMML). Of these, 565 with t-MN were identified. The median age was 54 years (range, 16–80 years). Three hundred and ninety-eight patients had AML, 154 had MDS, and 13 had CMML. Lymphoma and breast cancer were the major previous malignancies. Favorable karyotypes were detected in 84 cases, and poor karyotypes in 235. A total of 66% of patients were in non-remission at HCT. Overall survival (OS) at 3 years in t-MN was 31% (95% confidence interval [CI]: 27–35), equivalent to secondary-MN (32%, 95% CI: 30–34), and 44% in the de novo cohort (95% CI: 43–45). The cumulative incidence of relapse and non-relapse mortality (NRM) at 3 years was 40% and 33%, respectively. The outcome of HCT against t-MN in Japan was comparable to large-scale studies in Europe and the USA. (183 words)