Allogeneic Hematopoietic Cell Transplantation for Adult Chronic Myelomonocytic Leukemia

Hien Duong Liu, Kwang Woo Ahn, Zhen Huan Hu, Mehdi Hamadani, Taiga Nishihori, Baldeep Wirk, Amer Beitinjaneh, David Rizzieri, Michael R. Grunwald, Mitchell Sabloff, Richard F. Olsson, Ashish Bajel, Christopher Bredeson, Andrew Daly, Yoshihiro Inamoto, Navneet Majhail, Ayman Saad, Vikas Gupta, Aaron Gerds, Adriana Malone & 23 others Martin Tallman, Ran Reshef, David I. Marks, Edward Copelan, Usama Gergis, Mary Lynn Savoie, Celalettin Ustun, Mark R. Litzow, Jean Yves Cahn, Tamila Kindwall-Keller, Gorgun Akpek, Bipin N. Savani, Mahmoud Aljurf, Jacob M. Rowe, Peter H. Wiernik, Jack W. Hsu, Jorge Cortes, Matt Kalaycio, Richard Maziarz, Ronald Sobecks, Uday Popat, Edwin Alyea, Wael Saber

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Allogeneic hematopoietic cell transplantation (HCT) is potentially curative for patients with chronic myelomonocytic leukemia (CMML); however, few data exist regarding prognostic factors and transplantation outcomes. We performed this retrospective study to identify prognostic factors for post-transplantation outcomes. The CMML-specific prognostic scoring system (CPSS) has been validated in subjects receiving nontransplantation therapy and was included in our study. From 2001 to 2012, 209 adult subjects who received HCT for CMML were reported to the Center for International Blood and Marrow Transplant Research. The median age at transplantation was 57 years (range, 23 to 74). Median follow-up was 51 months (range, 3 to 122). On multivariate analyses, CPSS scores, Karnofsky performance status (KPS), and graft source were significant predictors of survival (P = .004, P = .01, P = .01, respectively). Higher CPSS scores were not associated with disease-free survival, relapse, or transplantation-related mortality. In a restricted analysis of subjects with relapse after HCT, those with intermediate-2/high risk had a nearly 2-fold increased risk of death after relapse compared to those with low/intermediate-1 CPSS scores. Respective 1-year, 3-year, and 5-year survival rates for low/intermediate-1 risk subjects were 61% (95% confidence interval [CI], 52% to 72%), 48% (95% CI, 37% to 59%), and 44% (95% CI, 33% to 55%), and for intermediate-2/high risk subjects were 38% (95% CI, 28% to 49%), 32% (95% CI, 21% to 42%), and 19% (95% CI, 8% to 29%). We conclude that higher CPSS score at time of transplantation, lower KPS, and a bone marrow graft are associated with inferior survival after HCT. Further investigation of CMML disease–related biology may provide insights into other risk factors predictive of post-transplantation outcomes.

Original languageEnglish (US)
Pages (from-to)767-775
Number of pages9
JournalBiology of Blood and Marrow Transplantation
Volume23
Issue number5
DOIs
StatePublished - May 1 2017

Fingerprint

Leukemia, Myelomonocytic, Chronic
Cell Transplantation
Transplantation
Confidence Intervals
Karnofsky Performance Status
Transplants
Recurrence
Bone Marrow
Disease-Free Survival
Multivariate Analysis
Survival Rate
Retrospective Studies
Survival
Mortality
Research

Keywords

  • Allogeneic hematopoietic cell transplantation
  • Chronic myelomonocytic leukemia
  • Transplantation outcomes

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Liu, H. D., Ahn, K. W., Hu, Z. H., Hamadani, M., Nishihori, T., Wirk, B., ... Saber, W. (2017). Allogeneic Hematopoietic Cell Transplantation for Adult Chronic Myelomonocytic Leukemia. Biology of Blood and Marrow Transplantation, 23(5), 767-775. https://doi.org/10.1016/j.bbmt.2017.01.078

Allogeneic Hematopoietic Cell Transplantation for Adult Chronic Myelomonocytic Leukemia. / Liu, Hien Duong; Ahn, Kwang Woo; Hu, Zhen Huan; Hamadani, Mehdi; Nishihori, Taiga; Wirk, Baldeep; Beitinjaneh, Amer; Rizzieri, David; Grunwald, Michael R.; Sabloff, Mitchell; Olsson, Richard F.; Bajel, Ashish; Bredeson, Christopher; Daly, Andrew; Inamoto, Yoshihiro; Majhail, Navneet; Saad, Ayman; Gupta, Vikas; Gerds, Aaron; Malone, Adriana; Tallman, Martin; Reshef, Ran; Marks, David I.; Copelan, Edward; Gergis, Usama; Savoie, Mary Lynn; Ustun, Celalettin; Litzow, Mark R.; Cahn, Jean Yves; Kindwall-Keller, Tamila; Akpek, Gorgun; Savani, Bipin N.; Aljurf, Mahmoud; Rowe, Jacob M.; Wiernik, Peter H.; Hsu, Jack W.; Cortes, Jorge; Kalaycio, Matt; Maziarz, Richard; Sobecks, Ronald; Popat, Uday; Alyea, Edwin; Saber, Wael.

In: Biology of Blood and Marrow Transplantation, Vol. 23, No. 5, 01.05.2017, p. 767-775.

Research output: Contribution to journalArticle

Liu, HD, Ahn, KW, Hu, ZH, Hamadani, M, Nishihori, T, Wirk, B, Beitinjaneh, A, Rizzieri, D, Grunwald, MR, Sabloff, M, Olsson, RF, Bajel, A, Bredeson, C, Daly, A, Inamoto, Y, Majhail, N, Saad, A, Gupta, V, Gerds, A, Malone, A, Tallman, M, Reshef, R, Marks, DI, Copelan, E, Gergis, U, Savoie, ML, Ustun, C, Litzow, MR, Cahn, JY, Kindwall-Keller, T, Akpek, G, Savani, BN, Aljurf, M, Rowe, JM, Wiernik, PH, Hsu, JW, Cortes, J, Kalaycio, M, Maziarz, R, Sobecks, R, Popat, U, Alyea, E & Saber, W 2017, 'Allogeneic Hematopoietic Cell Transplantation for Adult Chronic Myelomonocytic Leukemia', Biology of Blood and Marrow Transplantation, vol. 23, no. 5, pp. 767-775. https://doi.org/10.1016/j.bbmt.2017.01.078
Liu, Hien Duong ; Ahn, Kwang Woo ; Hu, Zhen Huan ; Hamadani, Mehdi ; Nishihori, Taiga ; Wirk, Baldeep ; Beitinjaneh, Amer ; Rizzieri, David ; Grunwald, Michael R. ; Sabloff, Mitchell ; Olsson, Richard F. ; Bajel, Ashish ; Bredeson, Christopher ; Daly, Andrew ; Inamoto, Yoshihiro ; Majhail, Navneet ; Saad, Ayman ; Gupta, Vikas ; Gerds, Aaron ; Malone, Adriana ; Tallman, Martin ; Reshef, Ran ; Marks, David I. ; Copelan, Edward ; Gergis, Usama ; Savoie, Mary Lynn ; Ustun, Celalettin ; Litzow, Mark R. ; Cahn, Jean Yves ; Kindwall-Keller, Tamila ; Akpek, Gorgun ; Savani, Bipin N. ; Aljurf, Mahmoud ; Rowe, Jacob M. ; Wiernik, Peter H. ; Hsu, Jack W. ; Cortes, Jorge ; Kalaycio, Matt ; Maziarz, Richard ; Sobecks, Ronald ; Popat, Uday ; Alyea, Edwin ; Saber, Wael. / Allogeneic Hematopoietic Cell Transplantation for Adult Chronic Myelomonocytic Leukemia. In: Biology of Blood and Marrow Transplantation. 2017 ; Vol. 23, No. 5. pp. 767-775.
@article{06fdf144366c43dca4f8529a019bf2f5,
title = "Allogeneic Hematopoietic Cell Transplantation for Adult Chronic Myelomonocytic Leukemia",
abstract = "Allogeneic hematopoietic cell transplantation (HCT) is potentially curative for patients with chronic myelomonocytic leukemia (CMML); however, few data exist regarding prognostic factors and transplantation outcomes. We performed this retrospective study to identify prognostic factors for post-transplantation outcomes. The CMML-specific prognostic scoring system (CPSS) has been validated in subjects receiving nontransplantation therapy and was included in our study. From 2001 to 2012, 209 adult subjects who received HCT for CMML were reported to the Center for International Blood and Marrow Transplant Research. The median age at transplantation was 57 years (range, 23 to 74). Median follow-up was 51 months (range, 3 to 122). On multivariate analyses, CPSS scores, Karnofsky performance status (KPS), and graft source were significant predictors of survival (P = .004, P = .01, P = .01, respectively). Higher CPSS scores were not associated with disease-free survival, relapse, or transplantation-related mortality. In a restricted analysis of subjects with relapse after HCT, those with intermediate-2/high risk had a nearly 2-fold increased risk of death after relapse compared to those with low/intermediate-1 CPSS scores. Respective 1-year, 3-year, and 5-year survival rates for low/intermediate-1 risk subjects were 61{\%} (95{\%} confidence interval [CI], 52{\%} to 72{\%}), 48{\%} (95{\%} CI, 37{\%} to 59{\%}), and 44{\%} (95{\%} CI, 33{\%} to 55{\%}), and for intermediate-2/high risk subjects were 38{\%} (95{\%} CI, 28{\%} to 49{\%}), 32{\%} (95{\%} CI, 21{\%} to 42{\%}), and 19{\%} (95{\%} CI, 8{\%} to 29{\%}). We conclude that higher CPSS score at time of transplantation, lower KPS, and a bone marrow graft are associated with inferior survival after HCT. Further investigation of CMML disease–related biology may provide insights into other risk factors predictive of post-transplantation outcomes.",
keywords = "Allogeneic hematopoietic cell transplantation, Chronic myelomonocytic leukemia, Transplantation outcomes",
author = "Liu, {Hien Duong} and Ahn, {Kwang Woo} and Hu, {Zhen Huan} and Mehdi Hamadani and Taiga Nishihori and Baldeep Wirk and Amer Beitinjaneh and David Rizzieri and Grunwald, {Michael R.} and Mitchell Sabloff and Olsson, {Richard F.} and Ashish Bajel and Christopher Bredeson and Andrew Daly and Yoshihiro Inamoto and Navneet Majhail and Ayman Saad and Vikas Gupta and Aaron Gerds and Adriana Malone and Martin Tallman and Ran Reshef and Marks, {David I.} and Edward Copelan and Usama Gergis and Savoie, {Mary Lynn} and Celalettin Ustun and Litzow, {Mark R.} and Cahn, {Jean Yves} and Tamila Kindwall-Keller and Gorgun Akpek and Savani, {Bipin N.} and Mahmoud Aljurf and Rowe, {Jacob M.} and Wiernik, {Peter H.} and Hsu, {Jack W.} and Jorge Cortes and Matt Kalaycio and Richard Maziarz and Ronald Sobecks and Uday Popat and Edwin Alyea and Wael Saber",
year = "2017",
month = "5",
day = "1",
doi = "10.1016/j.bbmt.2017.01.078",
language = "English (US)",
volume = "23",
pages = "767--775",
journal = "Biology of Blood and Marrow Transplantation",
issn = "1083-8791",
publisher = "Elsevier Inc.",
number = "5",

}

TY - JOUR

T1 - Allogeneic Hematopoietic Cell Transplantation for Adult Chronic Myelomonocytic Leukemia

AU - Liu, Hien Duong

AU - Ahn, Kwang Woo

AU - Hu, Zhen Huan

AU - Hamadani, Mehdi

AU - Nishihori, Taiga

AU - Wirk, Baldeep

AU - Beitinjaneh, Amer

AU - Rizzieri, David

AU - Grunwald, Michael R.

AU - Sabloff, Mitchell

AU - Olsson, Richard F.

AU - Bajel, Ashish

AU - Bredeson, Christopher

AU - Daly, Andrew

AU - Inamoto, Yoshihiro

AU - Majhail, Navneet

AU - Saad, Ayman

AU - Gupta, Vikas

AU - Gerds, Aaron

AU - Malone, Adriana

AU - Tallman, Martin

AU - Reshef, Ran

AU - Marks, David I.

AU - Copelan, Edward

AU - Gergis, Usama

AU - Savoie, Mary Lynn

AU - Ustun, Celalettin

AU - Litzow, Mark R.

AU - Cahn, Jean Yves

AU - Kindwall-Keller, Tamila

AU - Akpek, Gorgun

AU - Savani, Bipin N.

AU - Aljurf, Mahmoud

AU - Rowe, Jacob M.

AU - Wiernik, Peter H.

AU - Hsu, Jack W.

AU - Cortes, Jorge

AU - Kalaycio, Matt

AU - Maziarz, Richard

AU - Sobecks, Ronald

AU - Popat, Uday

AU - Alyea, Edwin

AU - Saber, Wael

PY - 2017/5/1

Y1 - 2017/5/1

N2 - Allogeneic hematopoietic cell transplantation (HCT) is potentially curative for patients with chronic myelomonocytic leukemia (CMML); however, few data exist regarding prognostic factors and transplantation outcomes. We performed this retrospective study to identify prognostic factors for post-transplantation outcomes. The CMML-specific prognostic scoring system (CPSS) has been validated in subjects receiving nontransplantation therapy and was included in our study. From 2001 to 2012, 209 adult subjects who received HCT for CMML were reported to the Center for International Blood and Marrow Transplant Research. The median age at transplantation was 57 years (range, 23 to 74). Median follow-up was 51 months (range, 3 to 122). On multivariate analyses, CPSS scores, Karnofsky performance status (KPS), and graft source were significant predictors of survival (P = .004, P = .01, P = .01, respectively). Higher CPSS scores were not associated with disease-free survival, relapse, or transplantation-related mortality. In a restricted analysis of subjects with relapse after HCT, those with intermediate-2/high risk had a nearly 2-fold increased risk of death after relapse compared to those with low/intermediate-1 CPSS scores. Respective 1-year, 3-year, and 5-year survival rates for low/intermediate-1 risk subjects were 61% (95% confidence interval [CI], 52% to 72%), 48% (95% CI, 37% to 59%), and 44% (95% CI, 33% to 55%), and for intermediate-2/high risk subjects were 38% (95% CI, 28% to 49%), 32% (95% CI, 21% to 42%), and 19% (95% CI, 8% to 29%). We conclude that higher CPSS score at time of transplantation, lower KPS, and a bone marrow graft are associated with inferior survival after HCT. Further investigation of CMML disease–related biology may provide insights into other risk factors predictive of post-transplantation outcomes.

AB - Allogeneic hematopoietic cell transplantation (HCT) is potentially curative for patients with chronic myelomonocytic leukemia (CMML); however, few data exist regarding prognostic factors and transplantation outcomes. We performed this retrospective study to identify prognostic factors for post-transplantation outcomes. The CMML-specific prognostic scoring system (CPSS) has been validated in subjects receiving nontransplantation therapy and was included in our study. From 2001 to 2012, 209 adult subjects who received HCT for CMML were reported to the Center for International Blood and Marrow Transplant Research. The median age at transplantation was 57 years (range, 23 to 74). Median follow-up was 51 months (range, 3 to 122). On multivariate analyses, CPSS scores, Karnofsky performance status (KPS), and graft source were significant predictors of survival (P = .004, P = .01, P = .01, respectively). Higher CPSS scores were not associated with disease-free survival, relapse, or transplantation-related mortality. In a restricted analysis of subjects with relapse after HCT, those with intermediate-2/high risk had a nearly 2-fold increased risk of death after relapse compared to those with low/intermediate-1 CPSS scores. Respective 1-year, 3-year, and 5-year survival rates for low/intermediate-1 risk subjects were 61% (95% confidence interval [CI], 52% to 72%), 48% (95% CI, 37% to 59%), and 44% (95% CI, 33% to 55%), and for intermediate-2/high risk subjects were 38% (95% CI, 28% to 49%), 32% (95% CI, 21% to 42%), and 19% (95% CI, 8% to 29%). We conclude that higher CPSS score at time of transplantation, lower KPS, and a bone marrow graft are associated with inferior survival after HCT. Further investigation of CMML disease–related biology may provide insights into other risk factors predictive of post-transplantation outcomes.

KW - Allogeneic hematopoietic cell transplantation

KW - Chronic myelomonocytic leukemia

KW - Transplantation outcomes

UR - http://www.scopus.com/inward/record.url?scp=85014101308&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85014101308&partnerID=8YFLogxK

U2 - 10.1016/j.bbmt.2017.01.078

DO - 10.1016/j.bbmt.2017.01.078

M3 - Article

VL - 23

SP - 767

EP - 775

JO - Biology of Blood and Marrow Transplantation

JF - Biology of Blood and Marrow Transplantation

SN - 1083-8791

IS - 5

ER -