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Golubovskaya et al. (Abstract)

Cellular Therapy and Transplantation (CTT), Vol. 3, No. 9
doi: 10.3205/ctt-2010-No9-abstract44
© The Authors. This abstract is provided under the following license: Creative Commons Attribution 3.0 Unported

Abstract accepted for "4th Raisa Gorbacheva Memorial Meeting on Hematopoietic Stem Cell Transplantation",
Saint Petersburg, Russia, September 18–20, 2010

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Myelodysplastic syndrome and acute myeloid leukemia (MDS/AML) in long-term survivors of aplastic anemia

Irina K. Golubovskaya, Abdulbasir A. Ganapiev, Alexander D. Kulagin, Sergey N. Bondarenko, Natalia V. Stancheva, Vladimir N. Vavilov, Igor A. Lisukov, Boris V. Afanasyev

R.M. Gorbacheva Memorial Institute of Children Hematology and Transplantation, Pavlov State Medical University, Saint-Petersburg, Russia

Correspondence: Irina K. Golubovskaya, R.M. Gorbacheva Memorial Institute of Children Hematology and Transplantation, Saint-Petersburg Pavlov State Medical University, 6/8, L. Tolstoy str., Saint-Petersburg, 197022, Russia, E-mail: golub@rambler.ru

Abstract

Purpose: To describe the incidence and treatment modalities of MDS/AML in long-term survivors of aplastic anemia (AA).

Patients and methods: We reviewed 161 patients (pts) with acquired AA who received immunosuppressive therapy (IST) or allogeneic bone marrow transplantation (allo-BMT) in two centers between March 1995 and June 2010. The median follow-up for survivors was 3.6 years (range, 0.1–13). Median age at AA diagnosis was 19.5 years.

Results: MDS/AML developed in 7 patients at a median time of 7 years (range, 1–16.5) after the diagnosis of AA. All cases occurred within the IST group and all of these patients were diagnosed with non-severe AA (NSAA). Cytogenetic analysis was performed in 6 patients, which revealed monosomy 7 in 5 pts and normal karyotype in 1 case. Three pts died during induction chemotherapy in disease progression. Four pts received allo-BMT: 2 from matched related donors (MRD), 1 from a haploidentical father, and 1 from a matched unrelated donor (MUD). After allo-BMT two pts are alive and in complete remission (1 received BMT from a MUD, and 1 from a MRD).

Conclusions: MDS/AML remains an actual problem in long-term survivors after IST, especially in patients with NSAA. Our data indicates that these patients ultimately have a poor prognosis with allogeneic bone marrow transplantation being the only curative option.

Keywords: aplastic anemia, immunosuppressive treatment, MDS, AML, bone marrow transplantation

 

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