LOW INCIDENCE OF MYELODYSPLASTIC SYNDROME FOLLOWING TRANSPLANTATION USING AUTOLOGOUS NONCRYOPRESERVED BONE-MARROW

Between May 1984 and October 1995 we performed 114 autologous stem cel l transplants for lymphoma in our centre; 77/114 (68%) were transplant ed after primary therapy. The conditioning regimen varied according to diagnosis; 26 patients were conditioned with melphalan and total body irradiation, 66 received melphalan and etoposide and the remainder (5 0) were conditioned with melphalan alone. The median follow-up Is 62 m onths. Only two new haematological malignancies have occurred, both in patients with Hodgkin's disease. One patient developed Ph+ chronic my eloid leukaemia 18 months posttransplant. In this case, because of the timing of the haematological disorder, we considered the malignancy t o be concurrent with or to have preceded the transplant. A second pati ent developed acute myeloid leukaemia 20 months post-transplant. She h ad been treated for Hodgkin's disease for 10 years and was transplante d in third complete remission. Cytogenetic analysis in this case showe d trisomy 11. We believe this to have been an unequivocal second malig nancy. Our finding of a 1.1% incidence of secondary haematological mal ignancy (95% CI 0.02-4.96) from a census population adds weight to the hypothesis that haematological problems post-transplant reflects prio r chemotherapy rather than toxicity from the transplant procedure itse lf.