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Prognostic impact of the conditioning intensity on outcomes after allogeneic transplantation for MDS with low blasts: a nationwide retrospective study by the adult MDS working group of the Japan Society for Transplantation and Cellular Therapy.
- Source :
-
Bone marrow transplantation [Bone Marrow Transplant] 2024 Aug; Vol. 59 (8), pp. 1107-1117. Date of Electronic Publication: 2024 May 07. - Publication Year :
- 2024
-
Abstract
- Poor prognostic factors, such as transfusion dependency and chromosomal risk, need to be considered in the indication of allogeneic hematopoietic cell transplantation (allo-HCT) for patients harboring myelodysplastic syndromes with less than 5% marrow blasts (MDS-Lo). We analyzed the post-transplant outcomes of 1229 MDS-Lo patients who received myeloablative (MAC)(n = 651), reduced-intensity (RIC)(n = 397), and non-myeloablative conditioning (NMAC) regimens (n = 181). The multivariate analysis revealed that the RIC group had better chronic graft-versus-host disease (GVHD)- and relapse-free survival (CRFS) (P = 0.021), and GVHD- and relapse-free survival (GRFS) than the MAC group (P = 0.001), while no significant differences were observed between the NMAC and MAC groups. In the subgroup analysis, the MAC group has better overall survival (P = 0.008) than the RIC group among patients with an HCT-comorbidity index (HCT-CI) score of 0, while the RIC group had better overall survival (P = 0.029) than the MAC group among those with an HCT-CI score ≥3. According to the type of conditioning regimen, total body irradiation 12 Gy-based MAC regimen showed better OS and CRFS than the other MAC regimen, and comparable outcomes to the RIC regimen. In conclusion, the RIC and NMAC regimens are promising options for MDS-Lo patients in addition to the MAC regimen.<br /> (© 2024. The Author(s), under exclusive licence to Springer Nature Limited.)
- Subjects :
- Humans
Retrospective Studies
Male
Female
Middle Aged
Adult
Japan
Aged
Prognosis
Transplantation, Homologous methods
Adolescent
Young Adult
Societies, Medical
Graft vs Host Disease etiology
Graft vs Host Disease mortality
Disease-Free Survival
Allografts
Transplantation Conditioning methods
Myelodysplastic Syndromes therapy
Myelodysplastic Syndromes mortality
Hematopoietic Stem Cell Transplantation methods
Subjects
Details
- Language :
- English
- ISSN :
- 1476-5365
- Volume :
- 59
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Bone marrow transplantation
- Publication Type :
- Academic Journal
- Accession number :
- 38714756
- Full Text :
- https://doi.org/10.1038/s41409-024-02297-0