Authors
Maria Chiara Di Chio, Emanuele Guido, Angelica Barone, Jenny Mantovani, Silva Ljevar, Chiara Bonini, Antonella Aiello, Valentina Monti, Daniele Lorenzini, Lucia Farina, Martina Pennisi, Paolo Corradini
Published in
European journal of haematology. Oct 28, 2026. Epub Oct 28, 2026.
Abstract
Therapy-related myeloid neoplasms (t-MN) are late complications of cancer therapies. We retrospectively analyzed 86 adults diagnosed from 2007 to 2025 with t-MN (acute myeloid leukemia [AML] n = 31, myelodysplastic neoplasms [MDS] n = 38, MDS/AML n = 17). We estimated overall survival (OS) and cumulative incidence of disease related mortality (DRM). Uni- and multivariable models identified predictors of mortality; interaction models defined the role of allogeneic hemopoietic stem cell transplantation (allo-HSCT) in elderly patients and complex karyotype (CK) t-MN. Median age at diagnosis was 65.5 years, previous cancer was solid in 29% or hematologic in 71%. Among 66/86 candidates to active therapy, 39/66 were candidates to allo-HSCT and 24 received it. In our cohort, we had demonstrated a high prevalence of adverse baseline genomics (47% of CK) and poor OS (11.94 months), partially mitigated by allo-HSCT (29.47 vs. 9.01 months, p = 0.028). In univariable and multivariable analysis, age ≥ 65 years and CK but not allo-HSCT were DRM predictors. In interaction models, age ≥ 65 years remained deleterious regardless of transplant whereas allo-HSCT could offset CK-related risk, supporting transplantation even in high-risk cytogenetics, when disease control and fitness criteria are met. Overall, t-MN remained highly lethal, with DRM primarily driven by age and CK; allo-HSCT attenuated cytogenetic risk.
PMID:
42951294
Bibliographic data and abstract were imported from PubMed on 29 Oct 2026.
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