Stem Cell Transplantation | Malignant Lymphoma | Risk Factors for Secondary Myelodysplasia & AML

 

The acturarial incidence of secondary myelodysplasia or AML at 10 years was 6.8%.

 

Parameters:

(1) number of prior chemotherapy regimens given to the patient

(2) number of days of pheresis required to collect enough stem cells for the transplant

(3) history of previous radiation therapy

 

Parameter	Finding	Points
number of prior chemotherapy regimens	< 4	0
	>= 4	1
number of days of pheresis	<= 5 days	0
	> 5 days	1
history of previous radiation therapy	no	0
	yes	1

 

where:

• The need for more days of pheresis to harvest adequate stem cells correlated with cyclophosphamide therapy and the use of salvage mobilization.

• My guess is that a chemotherapy regimen refers to a completed course of chemotherapy rather than to the need for an entirely different regimens.

• The odds ratios range from 3.6 (radiation therapy history) to 5.4 for the other 2 risk factors.

 

number of risk factors for secondary myelodysplasia =

= SUM(points for all 3 parameters)

 

Interpretation:

• minimum number of risk factors: 0

• maximum number of risk factors: 3

• The higher the number of risk factors the greater the risk of myelodysplasia.

Number of Risk Factors	Risk of Myelodysplasia
0	low
1	low to moderate
2	moderate
3	high