{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T19:20:42Z","timestamp":1774725642185,"version":"3.50.1"},"reference-count":35,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCO"],"published-print":{"date-parts":[[2001,4,15]]},"abstract":"<jats:p> PURPOSE: This report describes results of related or unrelated hematopoietic stem-cell transplants in 111 patients with treatment-related leukemia or myelodysplasia performed consecutively at the Fred Hutchinson Cancer Research Center between December 1971 and June 1998, and identifies patient and treatment characteristics associated with survival and relapse. <\/jats:p><jats:p> PATIENTS AND METHODS: At transplantation, 56 patients had treatment-related secondary acute myeloid leukemia (AML), 15 had refractory anemia with excess blasts in transition (RAEB-T), 23 had refractory anemia with excess blasts (RAEB), 15 had refractory anemia (RA), and two had refractory anemia with ringed sideroblasts (RARS). Conditioning regimens were total-body irradiation (TBI) and chemotherapy for 60 patients, busulfan (BU) 14 to 16 mg\/kg and cyclophosphamide (CY) 120 mg\/kg (BUCY) for 27 patients, BU targeted to 600 to 900 ng\/mL plasma steady-state concentration with 120 mg\/kg CY (BUCY-t) for 22 patients, and miscellaneous chemotherapy for two patients. The donors were HLA-identical or partially identical family members for 69 patients and unrelated donors for 42 patients. <\/jats:p><jats:p> RESULTS: The 5-year disease-free survival was 8% for TBI, 19% for BUCY, and 30% for BUCY-t (P = .006). The 5-year cumulative incidence of relapse was 40% for secondary AML, 40% for RAEB-T, 26% for RAEB, and 0% for RA or RARS (P = .0009). The 5-year cumulative incidence of nonrelapse mortality after TBI was 58%; after BUCY, 52%; and after BUCY-t, 42% (P = .02). <\/jats:p><jats:p> CONCLUSION: Patients at risk for treatment-related leukemia or myelodysplasia should be followed closely and be considered for stem-cell transplantation early in the course of myelodysplasia using conditioning regimens such as BUCY-t designed to reduce nonrelapse mortality. <\/jats:p>","DOI":"10.1200\/jco.2001.19.8.2134","type":"journal-article","created":{"date-parts":[[2017,2,24]],"date-time":"2017-02-24T06:37:31Z","timestamp":1487918251000},"page":"2134-2141","source":"Crossref","is-referenced-by-count":77,"title":["Hematopoietic Stem-Cell Transplantation for Treatment-Related Leukemia or Myelodysplasia"],"prefix":"10.1200","volume":"19","author":[{"given":"Robert P.","family":"Witherspoon","sequence":"first","affiliation":[{"name":"From the Clinical Research Division of the Fred Hutchinson Cancer Research Center, and Department of Medicine, University of Washington School of Medicine, Seattle, WA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H. Joachim","family":"Deeg","sequence":"additional","affiliation":[{"name":"From the Clinical Research Division of the Fred Hutchinson Cancer Research Center, and Department of Medicine, University of Washington School of Medicine, Seattle, WA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barry","family":"Storer","sequence":"additional","affiliation":[{"name":"From the Clinical Research Division of the Fred Hutchinson Cancer Research Center, and Department of Medicine, University of Washington School of Medicine, Seattle, WA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudio","family":"Anasetti","sequence":"additional","affiliation":[{"name":"From the Clinical Research Division of the Fred Hutchinson Cancer Research Center, and Department of Medicine, University of Washington School of Medicine, Seattle, WA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rainer","family":"Storb","sequence":"additional","affiliation":[{"name":"From the Clinical Research Division of the Fred Hutchinson Cancer Research Center, and Department of Medicine, University of Washington School of Medicine, Seattle, WA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frederick R.","family":"Appelbaum","sequence":"additional","affiliation":[{"name":"From the Clinical Research Division of the Fred Hutchinson Cancer Research Center, and Department of Medicine, University of Washington School of Medicine, Seattle, WA."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"233","reference":[{"key":"R1-086741","doi-asserted-by":"publisher","DOI":"10.1016\/S0889-8588(18)30259-4"},{"key":"R2-086741","unstructured":"Estey  EH:   Prognosis and therapy of secondary myelodysplastic syndromes.   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