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Late treatment-related mortality versus competing causes of death after allogeneic transplantation for myelodysplastic syndromes and secondary acute myeloid leukemia

Research output: Contribution to journalArticle

Johannes Schetelig, Liesbeth C. de Wreede, Michel van Gelder, Linda Koster, Jürgen Finke, Dietger Niederwieser, Dietrich Beelen, G. J. Mufti, Uwe Platzbecker, Arnold Ganser, Silke Heidenreich, Johan Maertens, Gerard Socié, Arne Brecht, Matthias Stelljes, Guido Kobbe, Liisa Volin, Arnon Nagler, Antonin Vitek, Thomas Luft & 4 more Per Ljungman, Ibrahim Yakoub-Agha, Marie Robin, Nicolaus Kröger

Original languageEnglish
Pages (from-to)686-695
Number of pages10
JournalLeukemia
Volume33
Issue number3
DOIs
Publication statusPublished - 1 Mar 2019

King's Authors

Abstract

The causes and rates of late patient-mortality following alloHCT for myelodysplastic syndromes or secondary acute myeloid leukemia were studied, to assess the contribution of relapse-related, treatment-related, and population factors. Data from EBMT on 6434 adults, who received a first alloHCT from January 2000 to December 2012, were retrospectively studied using combined land-marking, relative-survival methods and multi-state modeling techniques. Median age at alloHCT increased from 49 to 58 years, and the number of patients aged ≥65 years at alloHCT increased from 5 to 17%. Overall survival probability was 53% at 2 years and 35% at 10 years post-alloHCT. Survival probability at 5 years from the 2-year landmark was 88% for patients <45-year old and 63% for patients ≥65-year old at alloHCT. Cumulative incidence of nonrelapse mortality (NRM) for patients <45-year old at transplant was 7% rising to 25% for patients aged ≥65. For older patients, 31% of NRM-deaths could be attributed to population mortality. Favorable post-alloHCT long-term survival was seen; however, excess mortality-risk for all age groups was shown compared to the general population. A substantial part of total NRM for older patients was attributable to population mortality, information which aids the balanced explanation of post-HCT risk and helps improve long-term care.

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