{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T19:47:39Z","timestamp":1769197659557,"version":"3.49.0"},"reference-count":48,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"22","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCO"],"published-print":{"date-parts":[[2006,8,1]]},"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p> The risk factors for treatment-related myelodysplastic syndrome (t-MDS) and acute myelogenous leukemia (AML) after autologous stem-cell transplantation (ASCT) are similar to those that increase the risk of difficult stem-cell harvests. We reviewed our experience in 526 patients with lymphoma treated by ASCT to determine whether difficult stem-cell harvests predict for an increased risk of t-MDS\/AML. <\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p> Autologous peripheral stem cells were initially mobilized with granulocyte colony-stimulating factor (G-CSF; or granulocyte-macrophage colony-stimulating factor) alone (n = 334), etoposide and G-CSF (n = 166), or cyclophosphamide and G-CSF with or without etoposide (n = 26). Difficult harvests were those that required more than 5 days to collect enough stem cells and those that required additional attempts with etoposide and\/or cyclophosphamide plus G-CSF (n = 52). All patients were then treated with high-dose chemotherapy alone and observed for outcome. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> With a median follow-up time for surviving patients of 69 months, 20 patients developed t-MDS\/AML, for an actuarial incidence of 6.8% at 10 years. Pretransplantation characteristics, including age, diagnosis of non-Hodgkin's lymphoma or Hodgkin's disease, bone marrow involvement, prior radiation therapy, prior exposure to chemotherapy, lactate dehydrogenase at the time of ASCT, disease status, and method of stem-cell mobilization, were then analyzed with respect to the subsequent development of t-MDS\/AML. By multivariable analysis, prior exposure to radiation therapy, four or more chemotherapy regimens, and more than 5 days of apheresis needed to harvest enough stem cells were identified as independent risk factors for t-MDS\/AML. Bootstrap analysis confirmed these results. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p> These results suggest that identifiable pretransplantation factors predict for t-MDS\/AML after ASCT. <\/jats:p><\/jats:sec>","DOI":"10.1200\/jco.2006.06.0673","type":"journal-article","created":{"date-parts":[[2006,7,28]],"date-time":"2006-07-28T23:30:31Z","timestamp":1154129431000},"page":"3604-3610","source":"Crossref","is-referenced-by-count":63,"title":["Risk Factors Before Autologous Stem-Cell Transplantation for Lymphoma Predict for Secondary Myelodysplasia and Acute Myelogenous Leukemia"],"prefix":"10.1200","volume":"24","author":[{"given":"Matt","family":"Kalaycio","sequence":"first","affiliation":[{"name":"From the Departments of Hematology and Medical Oncology and Quantitative Health Sciences, The Cleveland Clinic Foundation, Taussig Cancer Center, Cleveland, OH"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"Rybicki","sequence":"additional","affiliation":[{"name":"From the Departments of Hematology and Medical Oncology and Quantitative Health Sciences, The Cleveland Clinic Foundation, Taussig Cancer Center, Cleveland, OH"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brad","family":"Pohlman","sequence":"additional","affiliation":[{"name":"From the Departments of Hematology and Medical Oncology and Quantitative Health Sciences, The Cleveland Clinic Foundation, Taussig Cancer Center, Cleveland, OH"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronald","family":"Sobecks","sequence":"additional","affiliation":[{"name":"From the Departments of Hematology and Medical Oncology and Quantitative Health Sciences, The Cleveland Clinic Foundation, Taussig Cancer Center, Cleveland, OH"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven","family":"Andresen","sequence":"additional","affiliation":[{"name":"From the Departments of Hematology and Medical Oncology and Quantitative Health Sciences, The Cleveland Clinic Foundation, Taussig Cancer Center, Cleveland, OH"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Kuczkowski","sequence":"additional","affiliation":[{"name":"From the Departments of Hematology and Medical Oncology and Quantitative Health Sciences, The Cleveland Clinic Foundation, Taussig Cancer Center, Cleveland, OH"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian","family":"Bolwell","sequence":"additional","affiliation":[{"name":"From the Departments of Hematology and Medical Oncology and Quantitative Health Sciences, The Cleveland Clinic Foundation, Taussig Cancer Center, Cleveland, OH"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"233","reference":[{"key":"R1","doi-asserted-by":"publisher","DOI":"10.1016\/S0889-8588(05)70340-3"},{"key":"R2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2003.07.113"},{"key":"R3","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1994.12.12.2535"},{"key":"R4","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1701781"},{"key":"R5","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V84.3.957.957"},{"key":"R6","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V83.12.3780.3780"},{"key":"R7","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2002-02-0634"},{"key":"R8","unstructured":"Bolwell BJ, Fishleder A, Andresen SW, et al: G-CSF primed peripheral blood progenitor cells in autologous bone marrow transplantation: Parameters affecting bone marrow engraftment. 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