1. ¹Hospital Universitario de Salamanca, Spain
2. ²Hospital Clínico de Barcelona, Spain
3. ³Hospital Marqués de Valdecilla de Santander, Spain
4. ⁴Hospital General de Murcia, Spain
5. ⁵Hospital de Santa Creu y Sant Pau de Barcelona, Spain
6. ⁶Hospital La Fé de Valencia, Spain

Correspondence: Dr MC del Cañizo, Servicio de Hematología, Hospital Universitario, Po San Vicente 58-182, Salamanca 37007, Spain. E-mail: concarol@usal.es

Received 2 October 2002; Accepted 6 June 2003.

Abstract

Allogeneic hematopoietic stem cell transplantation (HSCT) is the only curative therapy for patients with myelodysplastic syndromes (MDSs). We have analyzed the outcome of 81 patients who underwent an allogeneic transplant from an HLA-identical sibling donor. The overall survival (OS) was 31% and disease-free survival was 30% at 5.8 years. Transplant-related complications were the cause of death in 44% and disease progression in 16% of patients. Acute graft-versus-host disease (aGVHD) grades II–IV occurred in 32 cases (39%). Extensive chronic GVHD (cGVHD) was observed in 27% of patients. When the log-rank test was performed, we observed that patients transplanted more than 6 months after diagnosis, and those transplanted with bone marrow (BM) displayed a shorter survival (P=0.009 and 0.005, respectively). Patients who developed cGVHD showed a trend towards better OS (P=0.07). Patients receiving BM had a higher incidence of aGVHD (65 vs 50%) and less cGVHD (52 vs 30%), although the differences did not reach statistical significance. Moreover, patients who received PB-HSC displayed a faster engraftment (P=0.000) and showed a significantly lower early transplant-related mortality (14 vs 42%; P=0.006) and longer OS (P=0.005). In summary, our results show that hematopoietic transplantation should be performed as soon as possible in MDS patients and that PB is preferable to BM as a source of HSC.