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Myelodysplasias

HLA-matched allogeneic stem cell transplantation improves outcome of higher risk myelodysplastic syndrome A prospective study on behalf of SFGM-TC and GFM

Leukemia volume 29, pages 1496–1501 (2015)Cite this article

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Abstract

Allogeneic hematopoietic stem cell transplantation (HSCT) is considered the only a curative treatment in patients with higher risk myelodysplastic syndrome (MDS), although demethylating agents (DMA) have been reported to improve survival. The advantage of HSCT over other treatment comes from retrospective studies and the aim of the current study was to prospectively test this hypothesis, analyzing in particular patients from the pre-transplant period to avoid the selection bias of performing transplantation. This study was conducted to compare overall survival in MDS patients candidates to transplantation according to donor availability. The majority of patients (76%) received a treatment with DMA after registration, 69% had a human leukocyte antigen (HLA)-identical donor, 70% of whom were transplanted. Baseline patient and disease characteristics were similar according to donor availability. Four-year overall survival was significantly better in patients with an HLA matched donor (37%) compared to patients without donor (15%). There was also evidence that this overall survival advantage was because of transplantation. Mortality risk was decreased after transplantation but it became significant only after the second year post transplant, because of early transplant-related mortality. Our results appear to justify, in higher risk MDS, a transplantation approach in all potential candidates who have an HLA identical donor.

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Acknowledgements

We thank members of GFM and SFGM-TC for their participation and support. We thank Alix O’Meara for the English review. We thank Pierre Fabre for their contribution to this study.

Author Contributions

MR, GS, HD, ER, LA and PF designed research, RP and MR analyzed the data; all co-authors performed the research and recruited patients, MR, GS, LA, PF and RP wrote the paper and all authors gave their comments.

Author information

Authors and Affiliations

  1. Hematologie - Transplantati,

    M Robin, R P de Latour & G Socié

  2. on; Assistance Publique Hôpitaux de paris (AP-HP), Hôpital Saint Louis,

    M Robin, R P de Latour & G Socié

  3. Assistance Publique Hôpitaux de paris (AP-HP), Hôpital Saint Louis, Paris, France

    M Robin, R P de Latour & G Socié

  4. University Paris VII, Denis Diderot, Paris, France

    M Robin, R P de Latour, H Dombret, P Fenaux & G Socié

  5. Inserm U 1160, Paris, France

    M Robin, R P de Latour & G Socié

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

    R Porcher

  7. AP-HP, Hôpital Hôtel-Dieu, Centre d’Épidémiologie Clinique, Paris, France

    R Porcher

  8. Hématologie sénior, Assistance Publique Hôpitaux de paris (AP-HP), Hôpital Saint Louis and Hôpital Avicenne, Paris, France

    L Adès, H Dombret & P Fenaux

  9. Hématologie adulte, Assistance Publique Hôpitaux de paris (AP-HP), Hôpital Saint Louis, Paris, France

    E Raffoux

  10. Hématologie, CHU, Lyon, France

    M Michallet & E Wattel

  11. Hématologie, CHU, Angers, France

    S François

  12. Hématologie, CHU,UMR 5525 CNRS-UJF, Grenoble, France

    J-Y Cahn

  13. Hématologie, CHU, Reims, France

    A Delmer

  14. Hématologie, CHU, Bordeaux, France

    S Vigouroux

  15. Hématologie, CHU, Clermont-Ferrand, France

    J-O Bay

  16. Hématologie, Institut de Cancérologie de la Loire, Saint-Etienne, France

    J Cornillon

  17. Hématologie, CHU, Toulouse, France

    A Huynh

  18. Hématologie, hôpital de La Pitié Salpétrière Assistance Publique Hôpitaux de paris (AP-HP), Hôpital Saint Louis, Paris, France

    S Nguyen

  19. Hématologie, hôpital Saint-Antoine, Assistance Publique Hôpitaux de paris (AP-HP), Hôpital Saint Louis, Paris, France

    M-T Rubio

  20. Hématologie, CHU, Montpellier, France

    L Vincent

  21. Hématologie, CHU, Poitiers, France

    N Maillard

  22. Hématologie CHU, Amiens, France

    A Charbonnier

  23. Hématologie CHU, Caen, France

    O Reman

Authors
  1. M Robin
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  15. M-T Rubio
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  16. L Vincent
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  18. A Charbonnier
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  19. R P de Latour
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  21. H Dombret
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  22. P Fenaux
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  23. G Socié
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Corresponding author

Correspondence to M Robin.

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Robin, M., Porcher, R., Adès, L. et al. HLA-matched allogeneic stem cell transplantation improves outcome of higher risk myelodysplastic syndrome A prospective study on behalf of SFGM-TC and GFM. Leukemia 29, 1496–1501 (2015). https://doi.org/10.1038/leu.2015.37

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