Allogeneic haematopoietic SCT for chronic myelomonocytic leukaemia: a single-centre experience

Haematopoietic SCT (HSCT) offers the only potentially curative option in chronic myelomonocytic leukaemia (CMML). In this study, we report on single-centre results of 18 patients with CMML who have undergone allogeneic HSCT. The median age of patients was 54 years. Seven patients had AML, which had transformed from CMML. Overall, 11 patients received stem cells from an unrelated donor. A total of 15 patients received a T-cell-depleted fludarabine/BU-based reduced-intensity conditioning HSCT. The actuarial 3-year OS, non-relapse mortality (NRM) and relapse incidence for the cohort was 31 +/- 11%, 31 +/- 14% and 47 +/- 13%, respectively. Patients with favourable cytogenetics had a 3-year disease-free survival of 65 +/- 17%, whereas none of the seven patients with intermediate or poor risk cytogenetics survived beyond 2 years (P < 0.01). No patients with favourable risk cytogenetics died from NRM causes, while the 2-year NRM for the intermediate/poor risk cytogenetics subgroup was 71 +/- 22% (P < 0.02). In terms of disease status at transplantation, patients who had < 5% BM blasts had a 3-year disease-free survival of 46.9 +/- 19% compared with those with > 5% blasts at the time of transplantation (that is, 20.0 +/- 13%). Recipient age, type of conditioning regimen or stem cell dose did not have a significant impact on overall outcomes. Our data support existing evidence that allogeneic HSCT is a feasible therapeutic option for CMML, with the ability to attain long-term remission among patient subgroups. Bone Marrow Transplantation (2010) 45, 1502-1507; doi:10.1038/bmt.2009.375; published online 25 January 2010