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Allogeneic haematopoietic stem cell transplant in patients with lower risk myelodysplastic syndrome: a retrospective analysis on behalf of the Chronic Malignancy Working Party of the EBMT

Robin, M
Author Robin, M Hôpital Saint-Louis, Service d'Hématologie-Greffe, Assistance Publique Hôpitaux de Paris, Paris, France
Porcher, R
Author Porcher, R Team METHODS, Epidemiology and Statistics Sorbonne Paris Cité Research Centre UMR 1153, Inserm, Paris Descartes University, Paris, France AP-HP, Hôpital Hôtel-Dieu, Centre d'Épidémiologie Clinique, Paris, France
Zinke-Cerwenka, W
Author Zinke-Cerwenka, W Medical University of Graz, Hematology Department, Graz, Austria
van Biezen, A
Author van Biezen, A EBMT Data Office, Leiden, The Netherlands
Volin, L
Author Volin, L Helsinki University Central Hospital, Hematology Department, Helsinki, Finland
Mufti, G
Author Mufti, G King's College Hospital, Hematology Department, London, UK
Craddock, C
Author Craddock, C Queen Elizabeth Hospital, Hematology Department, Birmingham, UK
Finke, J
Author Finke, J Universitatsklinikum, Hematology Department, Freiburg, Germany
Richard, C
Author Richard, C Hospital de Valdecilla, Hematology Department, Santander, Spain
Passweg, J
Author Passweg, J University Hospital, Hematology Department, Basel, Switzerland
Peniket, A
Author Peniket, A Oxford University Hospital NHS Trust, Hematology Department, Oxford, UK
Maertens, J
Author Maertens, J Uz Gasthuisberg, Hematology Department, Leuven, Belgium
Sucak, G
Author Sucak, G Gazi University, Hematology Department, Ankara, Turkey
Gedde-Dahl, T
Author Gedde-Dahl, T Rikshospitalet, Oslo, Norway
Vitek, A
Author Vitek, A Institute of Hematology and Blood Transfusion, Prague, Czech Republic
Nagler, A
Author Nagler, A Hematology Division, Chaim Sheba Medical Center, Tel Hashomer, Israel
Blaise, D
Author Blaise, D IPC, Hematology Department, Marseille, France
Beelen, D
Author Beelen, D University Hospital, Hematology Department, Essen, Germany
Maillard, N
Author Maillard, N CHU, Hematology Department, Poitiers, France
Schwerdtfeger, R
Author Schwerdtfeger, R Center of Bone Marrow Transplantation, Wiesbaden, Germany
de Witte, T
Author de Witte, T University Medical Centre St Radboud, Hematology Department, Nijmegen, Netherlands
Kroger, N
Author Kroger, N University Hospital, Hematology Department, Hamburg, Germany

Bone marrow transplantation. 2017 Feb ; 52 (2) : 209-215. [epub] 20161107

Bone Marrow Transplant
ISSN 1476-5365 | 0268-3369
Source

Language English Country Great Britain, England Media print-electronic

Document type Journal Article

Persistent link https://www.medvik.cz/link/pmid27819688

PubMed 27819688
DOI 10.1038/bmt.2016.266
PII: bmt2016266
Knihovny.cz E-resources

MeSH
Allografts MeSH
Humans MeSH
Survival Rate MeSH
Follow-Up Studies MeSH
Disease-Free Survival MeSH
Anemia, Refractory, with Excess of Blasts mortality therapy MeSH
Registries * MeSH
Risk Factors MeSH
Hematopoietic Stem Cell Transplantation MeSH
Check Tag
Humans MeSH
Male MeSH
Female MeSH
Publication type
Journal Article MeSH

We report a retrospective analysis of 246 myelodysplastic syndrome (MDS) patients in the EBMT (The European Society for Blood and Marrow Transplantation) database who were transplanted for International Prognostic Scoring System (IPSS) low or intermediate-1 disease. The majority of these patients (76%) were reclassified as intermediate or higher risk according to R-IPSS. The 3-year overall survival (OS) and PFS were 58% and 54%, respectively. In a multivariate analysis, adverse risk factors for PFS were marrow blast percentage (hazard ratio (HR): 1.77, P=0.037), donor/recipient CMV serostatus (donor-/recipient+: HR: 2.02, P=0.011) and source of stem cells (marrow and non-CR: HR: 5.72, P<0.0001, marrow and CR: HR: 3.17, P=0.027). Independent risk factors for OS were disease status at time of transplant and the use of in vivo T-cell depletion (TCD). Patients who did not receive TCD and were transplanted from an unrelated donor had worse OS (HR: 4.08, P<0.0001). In conclusion, 'lower' risk MDS patients have better outcome than those with 'higher risk' after haematopoietic stem cell transplant (HSCT). Selecting the right source of stem cells, a CMV-positive donor for CMV-positive patients and using in vivo TCD results in the best outcome in these patients. More studies are needed to evaluate the role of HSCT in these patients as compared with conventional treatment.

AP HP Hôpital Hôtel Dieu Centre d'Épidémiologie Clinique Paris France

Center of Bone Marrow Transplantation Wiesbaden Germany

CHU Hematology Department Poitiers France

EBMT Data Office Leiden The Netherlands

Gazi University Hematology Department Ankara Turkey

Helsinki University Central Hospital Hematology Department Helsinki Finland

Hematology Division Chaim Sheba Medical Center Tel Hashomer Israel

Hôpital Saint Louis Service d'Hématologie Greffe Assistance Publique Hôpitaux de Paris Paris France

Hospital de Valdecilla Hematology Department Santander Spain

Institute of Hematology and Blood Transfusion Prague Czech Republic

IPC Hematology Department Marseille France

King's College Hospital Hematology Department London UK