Allogeneic Hematopoietic Cell Transplantation in Patients with Therapy-Related Myeloid Neoplasm after Breast Cancer: A Study of the Chronic Malignancies Working Party of the EBMT

Introduction: Therapy-related myeloid neoplasms (t-MNs) account for about 10 to 20% of all cases of AML and MDS. Allogenic hematopoietic cell transplantation (allo-HCT) is considered as the only curative treatment in this high-risk setting. Given the rise of long-term cancer survivors, an increasing number of patients are expected to become transplant candidates. Physicians are concerned about the frailty and the risk of recurrence of primary cancer. In this retrospective registry-based study, we focused on patients with t-MN secondary to breast cancer radio- and/or chemotherapy, and collected information about the outcomes and complications after allo-HCT. Methods and results: In the EBMT registry we identified 252 female adult patients who underwent an allo-HCT between 2006 and 2016 for t-MN secondary to breast cancer treatment. Median age at transplantation was 57 years, and the median time from the breast cancer diagnosis to t-MN diagnosis and subsequent allo-HCT were 3.7 and 4.6 years, respectively. The indication for allo-HCT was AML and MDS in 77% and 23% of cases, respectively. Sixty-seven% of patients were in complete remission (CR) of their t-MN at the time of transplant. Abnormal karyotype was recorded in 40% of cases. A reduced Karnofsky performance status (KPS Conclusions: Our study shows that allo-HCT can be safely performed in patients with t-MN secondary to treatment to breast cancer. A major drawback is the relapse of the primary disease which nevertheless appeared a rare event. Tight collaboration and multidisciplinary discussion between the oncologist and the hematologist are fundamental, and an adequate follow-up for the solid malignancy is essential thereafter. Download : Download high-res image (676KB) Download : Download full-size image Figure 1 . Disclosures Ganser: Novartis: Consultancy; Celgene: Consultancy. Scheid: Takeda: Honoraria, Research Funding; Novartis: Honoraria, Research Funding; Amgen: Honoraria; Janssen: Honoraria, Research Funding; BMS: Honoraria. Yakoub-Agha: Celgene: Honoraria; Novartis: Honoraria; Gilead/Kite: Honoraria, Other: travel support; Janssen: Honoraria; Jazz Pharmaceuticals: Honoraria.