Secondary leukaemia and myelodysplasia after autografting for lymphoma: results from the EBMT

Between 1978 and 1996 more than 7500 lymphoma transplants have been reporte d to the European Bone Marrow Transplantation (EBMT) Lymphoma Registry, Thi s has been examined to establish the incidence of secondary leukaemia and m yelodysplasia and to relate this to possible prognostic factors, 131 centre s representing 4998 patients responded to a questionnaire. This identified 66 patients with post transplant myelodysplastic syndrome (MDS)/acute myelo id leukaemia (AML). The actuarial risk for MDS/AML at 5 years post-transpla nt (+/-95% CI) was 4.6% (3.1-6.8) for Hodgkin's disease and 3.0% (2.0-4.3) for non-Hodgkins lymphoma. Multivariate analysis for all patients demonstra ted an effect of age at transplant, radiotherapy at conditioning, number of transplants and interval between diagnosis and transplant as risk factors. For patients with NHL, grade of histology was important (low grade > inter mediate or high-grade): for Hodgkin's disease, female sex was identified as a risk factor, These Endings suggest that the incidence of MDS/AML may not be greater following an autograft than after conventional chemotherapy.