Genetic profiling of people undergoing allogeneic hematopoietic stem-cell transplantation for myelodysplastic syndrome (MDS) can help categorize patients and determine the optimal conditioning regimen, according to a study involving more than 1,500 individuals.

Investigators looked at the link between mutations and transplant outcomes, including overall survival, relapse, and death without relapse. Among the results:

• TP53 mutations were seen in 2 of every 10 patients; they were linked with shorter survival and a shorter time to relapse.
• In patients ≥40 years of age without TP53 mutations, RAS pathway mutations were linked with shorter survival.
• The presence of JAK2 mutations was also linked with shorter survival in this group.
• The effect of TP53 mutations was similar in patients who received reduced-intensity and myeloablative conditioning regimens.
• Conversely, the effect of RAS pathway mutations was seen only with reduced-intensity conditioning.