Table 4.
Allogeneic hematopoietic transplant studies in patients with CMML
| Patien ts |
Medi an age |
Conditioni ng |
Cell source |
DF S/ PFS % |
OS % |
TRM/NR M % |
Relapse % |
Median follow up, months |
Factors predictive of OS |
|
|---|---|---|---|---|---|---|---|---|---|---|
| Zang et al (2000)10 | 21 | 47 | MAC: 21 RIC: 0 | BM: 21 PB: 0 | 25 (3 yrs) | 39 (3 yrs) | 34 | 23 | Unknown | Patients transplanted early (< 12 months from diagnosis) had better survival. |
| Kroger et al (2002)11 | 50 | 44 | MAC: 50 RIC:0 | BM: 40 PB: 9 | 18 (5 yrs) | 21 (5 yrs) | 52 | 49 | 40 (range, 11 to 110) | No correlation |
| Mittal et al (2004)12 | 8 | 51 | MAC: 4 RIC: 4 | BM: 4 PB: 4 | 37 (2 yrs) | 47 (2 yrs) | 13 | 63 | 17.5 | Number too small |
| Kerbauy et al (2005)13 | 43 | 48 | MAC: 41 RIC: 2 | BM: 23 PB: 20 | 41 (4 years) | 41 (4 years) | 34 | 23 (4 years) | 69 (range, 7 to 171) | MDAPS not correlative. Higher comorbidity scores associated with worse OS |
| Elliot et al (2006)14 | 17 | 50 | MAC:16 RIC: 1 | BM: 8 PB: 7 | 18 (3 yrs) | 18 (3 yrs) | 41 | 41 | 34.5 | No correlation |
| Laport et al (2008)15 | 7 | 59 | MAC: 0 RIC: 7 | Unknown, likely PB | 43 (3 yrs) | 43 (3 yrs) | 32 (3 years) | 57 | 47 (range, 6 to 89) | Number too small |
| Krishnamur thy et al (2010)14 | 18 | 54 | MAC:1 RIC 17 | BM: 18 PB: 36 | 31% (3 yrs) | 22 | 44 | 40 (range, 1 to 59) | None | |
| Eissa et al (2011)23 | 85 | 51 | MAC: 58 RIC: 27 | BM: 32 PB: 53 | 40 (10 yrs) | 42 (5 years) | 35 (10 years) | 27 (10 yrs) | 62 (range, 6 to 229) | MDAPS not correlative. Mortality negatively correlated with pre-HCT hematocrit and increased high-risk cytogenetics, higher HCT comorbidity index, and increased age |
| Lim et al (2013)24 | 7 | 43 | MAC: 3 RIC: 7 | BM: 2 PB: 7 | 51 (5 years) | 42% (5 years) | 14 | 29 (5 years) | 47.5 (range, 4.6 to 98.8) | Number too small |
| Park et al (2013)25 | 73 | 53 | MAC: 30 RIC: 43 | BM: 27 PB: 46 | 29 (3 years) | 42 (2 years) 32 (3 years) | 36 (3 years) | 29 (3 years) | 23 (range, 1–145) | Palpable SPM, transplant performed prior to 2004 correlated with poorer OS |
| Bajel et al (2014)26 | 57 | 56 | MAC:28 RIC: 29 | BM: 3 PB: 54 | 40 (6 years) | 27 (6 years) | 39 (6 years) | 35 (6 years) | 15.3 (range, 0.6 to 154) | In multivariate analysis, age < 50yo, non-sibling donor, and lymphocyte count > 2.9 × 109/L were associated with worse OS and PFS. Bone marrow blasts pre-transplant were associated with higher risk of relapse. |
| Sanchez et al (2014)27 | 28 | 60 | MAC: 16 (T-cell depleted) RIC: 12 | BM: 2 PB: 23 Cord: 3 | 74 (3 years) | 71 (3 years) | 7 (1 year) | 13 (1 year) | 39.6 (range, 3 to 35) | |
| Symeonidis et al (2015)17 | 513 | 53 | MAC: 249 (52%) RIC: 226 (48%) | BM: 119 (23%) PB: 394 (77%) | 27% (4 years) | 33% (4 years) | 31% (1 year) 41% (4 years) | 32 (4 years) | Patients transplanted in CR had lower probability for non-relapse death and longer survival. | |
| Kongtim et al (2016)18 | 83 | 57 | MAC: 64 (77%) | BM: 35 (42%) PB: 48 (58%) | 34% (3 years) | CMML-1/2: 36% (3 years) CMML/A ML: 32% (3 years) | 25% (day 100) 31% (1 year) | 33% (3 years) | 48 | Use of HMA therapy was associated with lower relapse at 3 years (22% compared to 35%, p=0.03) and higher PFS at 3 years (43% compared to 27%, p=0.04) |
List of abbreviations: myeloablative (MAC), reduced intensity conditioning (RIC), bone marrow (BM), peripheral blood (PB), disease free survival (DFS), progression free survival (PFS), overall survival (OS), transplant related mortality (TRM), nonrelapsed mortality (NRM), MDAPS (MD Anderson Prognostic Score)