Evaluating the risk of developing acute myeloid leukemia or myelodysplastic syndrome after a stem cell transplant

This study evaluated the risk of acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS) development in patients with lymphoma and myeloma after an autologous stem cell transplant (autoSCT). This study concluded that this risk is quite high after autoSCT in these patients.

AML and MDS are known long-term complications of cancer therapy. These are secondary cancers of blood cells. This means that they may develop after exposure to anti-cancer therapies for a previous cancer, such as high doses of chemotherapy or radiation therapy.

High-dose chemotherapy with or without radiation therapy is required before autoSCT. This gets rid of any remaining cancer cells. Then, the patient’s own healthy cells are collected and reintroduced back into the patient. Whether patients with Hodgkin’s lymphoma (HL), non-Hodgkin’s lymphoma (NHL), or plasma cell myeloma (PCM) are at risk for developing AML or MDS after autoSCT remains under investigation.

This study involved the records of 9028 patients who underwent autoSCT. Patients had HL (10.1%), NHL (39.3%), or PCM (50.6%). 2.70% (HL), 12.5%% (NHL), and 7.27% (PCM) of patients previously received 3 or more lines of chemotherapy. Patients were followed-up for an average of 90 to 110 months.

Overall, 3.7% of patients were diagnosed with AML or MDS after the transplant. Of these, 22.4% were AML and 77.6% were MDS.

In patients with HL, certain risk factors were significantly associated with a higher risk of developing AML or MDS. These included age over 45 (4.5 to 5.6-fold) or having radiation therapy rather than chemotherapy before the transplant (4.0-fold).

This study concluded that there are substantial risks of developing AML and MDS after autologous SCT in patients with HL.

This study was retrospective, meaning it looked back in time to analyze data.

Talk to your care team about the potential risks of secondary cancers after a stem cell transplant.