The causes and rates of late patient-mortality following alloHCT for myelodysplastic syndromes or secondary acute myeloid leukemia were studied, to assess the contribution of relapse-related, treatment-related, and population factors. Data from EBMT on 6434 adults, who received a first alloHCT from January 2000 to December 2012, were retrospectively studied using combined land-marking, relative-survival methods and multi-state modeling techniques. Median age at alloHCT increased from 49 to 58 years, and the number of patients aged ≥65 years at alloHCT increased from 5 to 17%. Overall survival probability was 53% at 2 years and 35% at 10 years post-alloHCT. Survival probability at 5 years from the 2-year landmark was 88% for patients <45-year old and 63% for patients ≥65-year old at alloHCT. Cumulative incidence of nonrelapse mortality (NRM) for patients <45-year old at transplant was 7% rising to 25% for patients aged ≥65. For older patients, 31% of NRM-deaths could be attributed to population mortality. Favorable post-alloHCT long-term survival was seen; however, excess mortality-risk for all age groups was shown compared to the general population. A substantial part of total NRM for older patients was attributable to population mortality, information which aids the balanced explanation of post-HCT risk and helps improve long-term care.

Chaim Sheba Medical Center Tel Hashomer Israel

CHU de Lille LIRIC INSERM U995 Université de Lille 59000 Lille France

Deutsche Klinik für Diagnostik Wiesbaden Germany

DKMS Clinical Trials Unit Dresden Germany

EBMT Data Office Leiden Leiden The Netherlands

GKT School of Medicine London UK

Hannover Medical School Hannover Germany

Heinrich Heine Universität Düsseldorf Germany

Hopital St Louis Paris France

HUCH Comprehensive Cancer Center Helsinki Finland

Institute of Hematology and Blood Transfusion Prague Czech Republic

Karolinska University Hospital Stockholm Sweden

Leiden University Medical Center Leiden The Netherlands

Universitaetsklinikum Dresden Dresden Germany

University Hospital Eppendorf Hamburg Germany

University Hospital Essen Germany

University Hospital Gasthuisberg Leuven Belgium

University Hospital Leipzig Leipzig Germany

University Hospital Maastricht Maastricht The Netherlands

University of Freiburg Freiburg Germany

University of Heidelberg Heidelberg Germany

University of Münster Münster Germany

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