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Allogeneic hematopoietic stem cell transplantation for myelodysplastic syndrome in adolescent and young adult patients

Bone Marrow Transplantation volume 56, pages 2510–2517 (2021)Cite this article

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Abstract

Allogeneic hematopoietic stem cell transplantation (HSCT) is the only curable treatment option for adolescent and young adult (AYA) patients with myelodysplastic syndrome (MDS). The study aim was to evaluate epidemiological data and identify prognostic factors for AYA patients with MDS undergoing allogeneic HSCT. Here, 645 patients were selected from patients enrolled in a multicenter prospective registry for HSCT from 2000 to 2015. The primary endpoint was 3-year overall survival (OS). Survival rates were estimated using the Kaplan–Meier method. Prognostic factors were identified using the multivariable Cox proportional hazards model. The 3-year OS was 71.2% (95% confidence interval [CI]: 67.4–74.6%). In multivariable analysis, active disease status (adjusted hazard ratio: 1.54, 95% CI: 1.09–2.18, p = 0.016), poor cytogenetic risk (1.62, 1.12–2.36, p = 0.011), poor performance status (2.01, 1.13–3.56, p = 0.016), human leukocyte antigen (HLA)-matched unrelated donors (2.23, 1.39–3.59, p < 0.001), HLA-mismatched unrelated donors (2.16, 1.09–4.28, p = 0.027), and cord blood transplantation (2.44, 1.43–4.17, p = 0.001) were significantly associated with poor 3-year OS. In conclusion, in AYA patients with MDS the 3-year OS following allogeneic HSCT was 71.2%. Active disease status, poor cytogenetic risk, poor performance status, and donor sources other than related donors were associated with poor 3-year OS.

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Fig. 1: Overall survival, relapse and non-relapse mortality after hematopoietic stem cell transplantation.
Fig. 2: Engraftment and graft versus host disease.

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Acknowledgements

The authors thank the medical and nursing staff of our institution and would like to express their gratitude to the Japan Society of Clinical Research (http://www.japanscr.org/) for valuable support.

Author information

Authors and Affiliations

  1. Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Japan

    Yoshimitsu Shimomura & Takayuki Ishikawa

  2. Center for Community-Based Healthcare Research and Education, Shimane University, Shimane, Japan

    Masahiko Hara

  3. Department of Hematology/Oncology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan

    Takaaki Konuma

  4. Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan

    Hidehiro Itonaga

  5. Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan

    Noriko Doki

  6. Department of Hematology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan

    Yukiyasu Ozawa

  7. Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan

    Tetsuya Eto

  8. Department of Hematology, Toranomon Hospital, Tokyo, Japan

    Naoyuki Uchida

  9. Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan

    Jun Aoki & Takahiro Fukuda

  10. Division of Hematology and department of Medicine, Keio University School of Medicine, Tokyo, Japan

    Jun Kato

  11. Department of Hematology, Tohoku University Hospital, Miyagi, Japan

    Yasushi Onishi

  12. Division of Molecular Therapy, the Advanced Clinical Research Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan

    Satoshi Takahashi

  13. Department of Hematology and Oncology, Osaka University Graduate School of Medicine, Osaka, Japan

    Kentaro Fukushima

  14. Department of Hematology, Graduate School of Medicine Osaka City University, Osaka, Japan

    Hirohisa Nakamae

  15. Department of Hematology, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan

    Toshiro Kawakita

  16. Department of Hematology, Tokyo Women’s Medical University, Tokyo, Japan

    Junji Tanaka

  17. Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan

    Yoshiko Atsuta

  18. Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Yoshiko Atsuta

  19. Department of Hematology, Kanazawa University Hospital, Kanazawa, Japan

    Ken Ishiyama

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Correspondence to Yoshimitsu Shimomura.

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Shimomura, Y., Hara, M., Konuma, T. et al. Allogeneic hematopoietic stem cell transplantation for myelodysplastic syndrome in adolescent and young adult patients. Bone Marrow Transplant 56, 2510–2517 (2021). https://doi.org/10.1038/s41409-021-01324-8

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