Allogeneic hematopoietic stem cell transplantation (HCT) is not used frequently enough to treat myelodysplastic syndrome (MDS), especially in patients ≥65 years of age, according to a retrospective analysis involving 362 individuals.

Participants had MDS diagnosed between 2008 and 2015. Among the findings:

• 8 in every 10 were determined to be transplant-eligible.
• Transplant was indicated in 83% of those eligible.
• Two-thirds of those eligible were referred for transplant evaluation.
• Overall, one-third underwent transplant a median of 7.7 months from diagnosis.
• More than half were deemed ineligible for transplant due to metastatic solid organ malignancy.
• 4 in every 10 who were not transplanted experienced MDS-related death.
• After adjusting for certain variables, diagnosis between 2008-2011, age ≥65, and <5% blasts at diagnosis were linked with a lower likelihood of referral.
• Age ≥65, presence of ≥2 comorbidities, and <5% blasts were linked with lower likelihood of undergoing transplant.