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Acute Leukemia

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

Bone Marrow Transplantation volume 52, pages 209–215 (2017)Cite this article

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A Corrigendum to this article was published on 05 July 2017

Abstract

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.

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Acknowledgements

MR, RP, WZ-C and NK designed and analysed the study. RP did the statistical analysis. MR wrote the paper. All co-authors have read the paper, had opportunity to comment it and approved the final version. All co-authors provided patients. We thank all co-investigators who participated in this study providing patients from the European registry (see Appendix).

Author information

Authors and Affiliations

  1. Hôpital Saint-Louis, Service d'Hématologie-Greffe, Assistance Publique Hôpitaux de Paris, Paris, France

    M Robin

  2. Team METHODS, Epidemiology and Statistics Sorbonne Paris Cité Research Centre UMR 1153, Inserm, Paris Descartes University, Paris, France

    R Porcher

  3. AP-HP, Hôpital Hôtel-Dieu, Centre d'Épidémiologie Clinique, Paris, France

    R Porcher

  4. Hematology Department, Medical University of Graz, Graz, Austria

    W Zinke-Cerwenka

  5. EBMT Data Office, Leiden, The Netherlands

    A van Biezen

  6. Hematology Department, Helsinki University Central Hospital, Helsinki, Finland

    L Volin

  7. Hematology Department, King's College Hospital, London, UK

    G Mufti

  8. Hematology Department, Queen Elizabeth Hospital, Birmingham, UK

    C Craddock

  9. Hematology Department, Universitatsklinikum, Freiburg, Germany

    J Finke

  10. Hematology Department, Hospital de Valdecilla, Santander, Spain

    C Richard

  11. Hematology Department, University Hospital, Basel, Switzerland

    J Passweg

  12. Hematology Department, Oxford University Hospital NHS Trust, Oxford, UK

    A Peniket

  13. Hematology Department, Uz Gasthuisberg, Leuven, Belgium

    J Maertens

  14. Hematology Department, Gazi University, Ankara, Turkey

    G Sucak

  15. Rikshospitalet, Oslo, Norway

    T Gedde-Dahl

  16. Institute of Hematology and Blood Transfusion, Prague, Czech Republic

    A Vitek

  17. Hematology Division, Chaim Sheba Medical Center, Tel Hashomer, Israel

    A Nagler

  18. Hematology Department, IPC, Marseille, France

    D Blaise

  19. Hematology Department, University Hospital, Essen, Germany

    D Beelen

  20. Hematology Department, CHU, Poitiers, France

    N Maillard

  21. Center of Bone Marrow Transplantation, Wiesbaden, Germany

    R Schwerdtfeger

  22. Hematology Department, University Medical Centre St Radboud, Nijmegen, Netherlands

    T de Witte

  23. Hematology Department, University Hospital, Hamburg, Germany

    N Kroger

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  1. M Robin
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  14. T Gedde-Dahl
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  16. A Nagler
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  17. D Blaise
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Correspondence to M Robin.

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Robin, M., Porcher, R., Zinke-Cerwenka, W. et al. 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. Bone Marrow Transplant 52, 209–215 (2017). https://doi.org/10.1038/bmt.2016.266

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