TY - JOUR
T1 - Isolated Clonal Cytogenetic Abnormalities after High-Dose Therapy
AU - Showel, Margaret M.
AU - Brodsky, Robert A.
AU - Tsai, Hua Ling
AU - Briel, Katlyn M.
AU - Kowalski, Jeanne
AU - Griffin, Constance A.
AU - Jones, Richard J.
N1 - Funding Information:
This work was supported in part by a grant from the National Institutes of Health ( P01 306 CA15396 ).
PY - 2014/8
Y1 - 2014/8
N2 - Therapy-related myeloid neoplasms (t-MN) are well-recognized complications of high-dose cytotoxic therapy (HDT), such as autologous stem cell transplantation (ASCT). Clonal marrow cytogenetic abnormalities (CMCA) in the setting of normal bone marrow pathology have also been reported after HDT, but their significance remains unclear. We retrospectively evaluated occurrences of CMCA and t-MN in 785 patients treated with HDT at Johns Hopkins University between 1997 and 2007. Most patients received ASCT, but 106 patients who received high-dose cyclophosphamide without ASCT were also included in this study, as this is our institutional standard for malignant and nonmalignant lymphoproliferative disorders in need of HDT. Twenty-two patients developed t-MN, with an estimated cumulative incidence of 3.5% at 4 years. Eleven patients developed isolated CMCA, either transient or persistent without pathologic evidence of t-MN. Altogether, only 20 of the patients with reported CMCA subsequently developed t-MN during the follow-up period. Therefore, in the absence of pathologic evidence of t-MN, CMCA should not be considered diagnostic of t-MN.
AB - Therapy-related myeloid neoplasms (t-MN) are well-recognized complications of high-dose cytotoxic therapy (HDT), such as autologous stem cell transplantation (ASCT). Clonal marrow cytogenetic abnormalities (CMCA) in the setting of normal bone marrow pathology have also been reported after HDT, but their significance remains unclear. We retrospectively evaluated occurrences of CMCA and t-MN in 785 patients treated with HDT at Johns Hopkins University between 1997 and 2007. Most patients received ASCT, but 106 patients who received high-dose cyclophosphamide without ASCT were also included in this study, as this is our institutional standard for malignant and nonmalignant lymphoproliferative disorders in need of HDT. Twenty-two patients developed t-MN, with an estimated cumulative incidence of 3.5% at 4 years. Eleven patients developed isolated CMCA, either transient or persistent without pathologic evidence of t-MN. Altogether, only 20 of the patients with reported CMCA subsequently developed t-MN during the follow-up period. Therefore, in the absence of pathologic evidence of t-MN, CMCA should not be considered diagnostic of t-MN.
KW - Chromosomal alterations in myeloid neoplasms
KW - Clonal cytogenetic abnormalities
KW - Treatment-related myeloid neoplasms
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U2 - 10.1016/j.bbmt.2014.03.033
DO - 10.1016/j.bbmt.2014.03.033
M3 - Article
C2 - 24732780
AN - SCOPUS:84904042361
SN - 1083-8791
VL - 20
SP - 1130
EP - 1138
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
IS - 8
ER -