Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Schlick, F.
Therapy-related myelodysplastic syndrome and acute myeloid leukemia after conventional therapy or autologous stem cell transplantation for non-Hodgkins lymphoma: a systematic review
[ Diplomarbeit ] Medical University of Graz; 2009. pp. 48
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Berghold Andrea
- Sill Heinz
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- Abstract:
- Background: In patients with non-Hodgkins lymphoma (NHL), an increase in long-term sequelae of cytotoxic therapies is being observed. Among those, therapy-related myelodysplastic syndrome (t-MDS) and acute myeloid leukemia (t-AML) are among the most severe ones. However, data on incidence of t-MDS/t-AML following NHL therapies are conflicting. The aim of this review is to systematically evaluate the incidence of t-MDS/t-AML following conventional treatment and high-dose therapy with autologous stem cell transplantation in patients with NHL. Methods: To pursue this goal, a systematic review was performed. We screened the databases MEDLINE, EMBASE and Cochrane Library as well as congress proceedings and reference lists, to identify original articles, published in English between 1970 and 2008, on t-MDS/t-AML after NHL. Of 4040 potentially appropriate articles, 35 fulfilled our strict inclusion criteria, reporting on a total of 93094 patients with NHL. Results: Thirty-one original articles reported on cohort studies, 4 on randomized controlled trials. In 16/35 articles the primary endpoint was evaluation of t-MDS/t-AML. Crude incidence was the most frequent measure of incidence, actuarial incidence and cumulative incidence were used occasionally. A total of 492 cases of t-MDS/t-AML were reported. In the group of conventionally treated patients, the crude incidence was between 0 and 8.2%, in the group with high-dose therapy and ASCT, between 0 and 13.6%. Due to missing data, subgroup analyses were not possible. Conclusion: The results of this systematic review show a higher incidence of t-MDS/t-AML after high-dose therapy and ASCT for patients with NHL as compared to conventional treatment. This indicates a role for toxicity in the pathogenesis of t-MDS/t-AML.