治疗相关的髓样新生物（t-MN）是具有侵略性的髓样新生物。预测异基因干细胞移植（alloSCT）后生存的因素尚不清楚。我们研究了t-MN诊断、alloSCT前和alloSCT后因素的预后效用。主要终点是3年总生存率（OS）、复发率（RI）和非复发性死亡率（NRM）。t-MDS和t-AML的alloSCT后OS没有差异（20.1与19.6个月，P = 1），尽管t-MDS的3年RI明显高于t-AML（45.1%与26.9%，P = 0.03）。在t-MDS中，alloSCT前单体染色体5（HR 3.63，P = 0.006）或单体染色体17（HR 11.81，P = 0.01）存在与更高的RI相关。复杂核型是唯一在所有时间点上对生存不利的因素。包含遗传信息产生了2个风险类别：高风险组定义为（TP53/BCOR/IDH1/GATA2/BCORL1）中存在病理变异的人群，以及标准风险组（余下的患者），其3年后的alloSCT后OS分别为0%和64.6%（P = 0.001）。我们得出结论，尽管alloSCT在一部分t-MN患者中是治愈的，但结果仍然不佳，特别是在高风险类别中。t-MDS患者，尤其是那些alloSCT前疾病持续存在的患者，存在着较高的复发风险。t-MN诊断时的疾病相关因素是alloSCT后生存预后的最具预测性的因素；疾病后期可用的因素的效用则是增量的。©2023.作者在Springer Nature Limited独家许可下发表。

Therapy-related myeloid neoplasms (t-MN) are aggressive myeloid neoplasms. Factors predicting post-allogeneic stem cell transplant (alloSCT) survival are not well-known. We studied the prognostic utility of factors at: t-MN diagnosis, pre-alloSCT, and post-alloSCT. Primary endpoints were 3-year overall survival (OS), relapse incidence (RI), and non-relapse mortality (NRM). Post-alloSCT OS did not differ between t-MDS and t-AML (20.1 vs. 19.6 months, P = 1), though t-MDS had a significantly higher 3-year RI compared to t-AML (45.1% vs. 26.9%, P = 0.03). In t-MDS, the presence of monosomy 5 (HR 3.63, P = 0.006) or monosomy 17 (HR 11.81, P = 0.01) pre-alloSCT were associated with higher RI. Complex karyotype was the only factor adversely influencing survival at all the timepoints. The inclusion of genetic information yielded 2 risk-categories: high-risk defined by the presence of pathogenic variants (PV) in (TP53/BCOR/IDH1/GATA2/BCORL1) and standard-risk (remainder of the patients) with 3-year post-alloSCT OS of 0% and 64.6%, respectively (P = 0.001). We concluded that while alloSCT was curative in a subset of t-MN patients, outcomes remained poor, specifically in the high-risk category. t-MDS patients, especially those with persistent disease pre-alloSCT were at increased risk of relapse. Disease-related factors at t-MN diagnosis were the most prognostic of post-alloSCT survival; utility of factors available later in the course, was incremental.© 2023. The Author(s), under exclusive licence to Springer Nature Limited.