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• W2300324008 abstract "18016 Background: Autologous graft versus host disease (GVHD) and engraftment syndrome (ES) are recognized complications after autologous transplantation, probably resulted from dysfunctional host immunity during hematopoietic recovery. Since impaired immunity has been associated with myelodysplastic syndrome, we explore the possible role of GVHD or ES in post-transplant myelodysplastic syndrome/acute myeloid leukemia (MDS). Methods: Consecutive patients with lymphoma (n = 414) undergoing autologous transplantation at our institution from 1/1993 to 6/2006. There were 253 males and 161 females; median age 50 years. There were 72 patients with Hodgkin's (HL) and 342 non-Hodgkin's lymphoma (NHL). 259 received TBI-based regimens and 155 non-TBI-based; 69 patients received transplantation of bone marrow (BM), 336 peripheral blood stem cells (PBSC) and 9 both. Results: Eleven patients had a second autologous transplant for progressive disease and three patients had a second allogeneic transplant for MDS. Ten patients developed severe engraftment syndrome (high fever, skin rash ± pulmonary infiltrate requiring systemic steroid); 33 patients had skin and 2 patients had gastrointestinal biopsies consistent with GVHD. The median follow-up of the patients is 6.0 years and median overall survival is 5.4 years. Twenty-three patients (5.6%) developed MDS with median time of onset of 4.3 years (range 8 months-8.9 years). Additional 5 patients developed clonal karyotypic abnormalities in the bone marrow without clinical MDS. Actuarial probabilities of developing MDS at 5 and 8 years after transplant are 6.9% and 17%, respectively. The development of MDS is independent of the diagnosis, stem cells or the conditioning regimens. Univariate analysis using logrank tests demonstrates that older age, advanced stage, the presence of ES, and longer intervals between the initial diagnoses to transplant as risk factors of developing MDS. Conclusions: Although overall incidence of MDS is only 5.6%, the actuarial risk at 8 years is up to 17% and is probably higher in selected patients. The association of engraftment syndrome to MDS is intriguing. While it may be just a chance association, it is conceivable that perturbation to the host immunity may play a role in the onset of MDS after transplant. No significant financial relationships to disclose." @default.
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• W2300324008 date "2008-05-20" @default.
• W2300324008 modified "2023-10-18" @default.
• W2300324008 title "Possible role of engraftment syndrome in myelodysplastic syndrome after autologous transplants" @default.
• W2300324008 doi "https://doi.org/10.1200/jco.2008.26.15_suppl.18016" @default.
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