We compared characteristics of myeloid neoplasms (MNs) following allogeneic hematopoietic cell transplantation (HCT) versus autologous HCT using a Japanese HCT registry database. Among 43 788 patients who underwent allogeneic (n = 18 874) or autologous HCT (n = 24 914) for non-myeloid malignancies or non-malignant diseases, 352 developed MNs. The cumulative incidence of MNs was lower after allogeneic HCT than after autologous HCT (0.3% vs. 1.8% at 10 years, respectively, p < .001). Compared with autologous HCT, MNs following allogeneic HCT developed in younger patients (median, 42 vs. 57 years old, respectively) and sooner after HCT (median, 16 vs. 33 months, respectively). Approximately half of MNs following allogeneic HCT were donor-derived and occurred later than recipient-derived MNs (median, 26 vs. 6 months, respectively, p = .003). In multivariate analysis, reduced-intensity conditioning and cord blood transplantation were associated with MN development after allogeneic HCT. Overall survival was similar in patients who developed MNs following allogeneic versus autologous HCT (18% vs. 22% at 5 years, respectively, p = .48). Patient age ≥ 55 years, the presence of previous HCT, AML subtype, and chromosome 5 or 7 abnormalities were adverse factors for overall survival after MN diagnosis. Further research is warranted to elucidate the mechanisms of MN development following allogeneic HCT.

中文翻译：

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异基因造血细胞移植后骨髓肿瘤的特征

我们使用日本 HCT 注册数据库比较了异基因造血细胞移植 (HCT) 与自体 HCT 后骨髓肿瘤 (MN) 的特征。 在因非髓系恶性肿瘤或非恶性疾病接受异基因（ n  = 18 874）或自体 HCT（n = 24 914）的43 788 例患者中，352 例发生 MN。异基因 HCT 后 MN 的累积发生率低于自体 HCT（10 年分别为 0.3% 和 1.8%，p < .001)。与自体 HCT 相比，异基因 HCT 后 MNs 在年轻患者（中位分别为 42 岁和 57 岁）和 HCT 后更早出现（中位数分别为 16 个月和 33 个月）。异基因 HCT 后大约一半的 MN 是供体来源的，发生时间晚于受体来源的 MN（中位数，分别为 26 个月和 6 个月，p  = .003）。在多变量分析中，降低强度调节和脐带血移植与异基因 HCT 后 MN 发展相关。异基因与自体 HCT 后发生 MN 的患者的总生存期相似（5 年分别为 18% 和 22%，p = .48)。患者年龄 ≥ 55 岁、既往存在 HCT、AML 亚型和 5 或 7 号染色体异常是 MN 诊断后总体生存的不利因素。需要进一步的研究来阐明异基因 HCT 后 MN 发展的机制。