Cytogenetic and myelodysplastic alterations after autologous hemopoietic stem cell transplantation

Secondary myelodysplastic syndrome/acute myelogenous leukemia (MDS/AML) are today considered a primary complication of autologous hematopoietic stem c ell transplantation. In our Center, 83 autografted patients underwent bone marrow (BM) biopsy and cytogenetic analysis at fixed intervals. Twelve pati ents developed non-clonal cytogenetic abnormalities and 10 patients clonal abnormalities, five of whom (three -7, one -5 and one t(9;11)) developed se condary MDS/AML. MDS was also diagnosed in two patients with a normal karyo type. In brief, seven patients (three males, four females; median age 36 ye ars) developed MDS/AML 12-48 months (median 14) after autografting. The FAB diagnosis was AML-M2 in one, chronic myelomonocytic leukemia in two and re fractory anemia with excess of blasts in transformation in four cases. Two patients presented a BM biopsy picture of MDS with fibrosis; none of them e xperienced leukemic transformation. Four MDS patients died, three of leukem ic transformation and one of BM insufficiency; the two remaining patients a re still living and untransformed. Our data underline the leukemogenic role of previous treatments, even if it is not possible to exclude that underly ing disease and/or conditioning therapy may be involved. (C) 1999 Elsevier Science Ltd. All rights reserved.