In this long-term study of 79 patients with therapy-related myelodysplasia (t-MDS) or acute myeloid leukemia (t-AML), 10-year disease-free survival (DFS) and OS rates in this high-risk patient cohort were 35% and 38%, respectively Non-relapse mortality rates were 23% at 5 years and 32% at 10 years for patients with a median age of 58 years (range, 20-76). Only 19 (24.1%) patients were in complete remission before allogeneic HCT. Cytogenetic aberrations were associated with shorter DFS and higher relapse risk, but persistent disease at the time of transplantation, an unrelated donor, and older patient age were not prognostic of shorter OS. The authors concluded that long-term survival in patients transplanted for t-MDS/t-AML is possible, even for refractory patients, and that early donor search and rapid transplantation are therefore warranted.
Early HCT Warranted in Therapy-Related MDS, AML