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Selecting Older MDS Patients for Allo-HSCT

Cancer; ePub 2017 Mar 21; Yucel, Saliba, et al

Cytogenetics and hematopoietic cell transplantation-comorbidity index (HCT-CI) can help select older patients with myelodysplastic syndrome (MDS) for allo-HSCT, according to a study involving 88 individuals.

Participants were ≥60 years and had allo-HSCT after reduced intensity conditioning. They had high-risk features, including older age, cytogenetic abnormalities consistent with monosomal karyotype (MKpos), histological subtype of RAEB-1 and RAEB-2 at diagnosis, and an HCT–comorbidity index ≥ 3. Among the results:

  • The 3-year incidence of progression was 26%; transplant-related mortality and overall survival rates were 35% and 41%, respectively.
  • MKpos was the only prognostic factor that increased the risk of disease progression.
  • HCT-CI ≥ 3 was linked with worse transplant-related mortality outcomes.
  • Overall survival rate in MKpos patients was 17%, it was 92% in patients with good-risk cytogenetics and HCT-CI <3.

Citation:

Yucel O, Saliba R, Rondon G, et al. Cytogenetics and comorbidity predict outcomes in older myelodysplastic syndrome patients after allogenic stem cell transplantation using reduced intensity conditioning. [Published online ahead of print March 21, 2017]. Cancer. doi:10.1002/cncr.30632.