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Allogeneic hematopoietic cell transplantation for myelodysplastic syndrome unclassifiable – a retrospective study on behalf of the Chronic Malignancies Working Party of the EBMT

Bone Marrow Transplantation volume 58, pages 222–225 (2023)Cite this article

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Myelodysplastic syndrome unclassifiable (MDS-U) encompasses an infrequent subtype of MDS, categorised into three entities [1]; MDS-U with 1% blasts (MDS-U-BL), MDS-U with single lineage dysplasia and pancytopenia (MDS-U-SLD-pan), and MDS-U with defining cytogenetic abnormalities (MDS-U-CG). There is a scarcity of evidence in the literature focused on MDS-U [2,3,4] and due to lack of robust disease characterisation, despite stringent diagnostic criteria, little is known about the inherent risk profile of MDS-U. Therapeutic decisions in MDS-U are frequently made using ‘general rules’ applied to all MDS cases, yet robust outcome and safety analyses for this specific group of patients are lacking.

Allogeneic hematopoietic cell transplantation (allo-HCT) remains the only established curative treatment for MDS, however non-relapse mortality (NRM) poses a significant concern. Previous studies have estimated that the median overall survival (OS) of a heterogeneous MDS-U population was 43 months [2], with only 1 MDS-U patient undergoing allo-HCT. In another study of 27 patients, those with MDS-U-BL had the shortest OS (median 23 months), and only 3 underwent allo-HCT [3]. The MDS-associated risks established with the use of the revised international prognostic scoring system (IPSS-R), cytogenetic abnormalities and molecular markers, marrow fibrosis, profound or symptomatic cytopenias as well as patient-specific characteristics are the mainstay of the decision-making process in the overall MDS population [5]. There remain very few studies, which analyse the indications for transplantation and outcomes for specific MDS subtypes [6]. To the best of our knowledge, there are no reports focussed on allo-HCT in MDS-U.

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Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We are indebted to all centres participating to the EBMT database, and especially the ones who contributed to this retrospective analysis.

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Authors and Affiliations

  1. University Clinical Centre, Medical University of Warsaw, Warsaw, Poland

    Joanna Drozd-Sokolowska

  2. EBMT Statistical Unit, Leiden, the Netherlands

    Luuk Gras

  3. EBMT Leiden Study Unit, Leiden, the Netherlands

    Nienke Zinger

  4. King Abdul - Aziz Medical City, Riyadh, Saudi Arabia

    Mohsen Al Zahrani

  5. University Hospital, Basel, Switzerland

    Jakob Passweg

  6. Nottingham University, Nottingham, UK

    Jenny Byrne

  7. Singapore General Hospital, Singapore, Singapore

    Aloysius Ho

  8. Peking University People´s Hospital, Institute of Haematology, Beijing, China

    Xiao-jun Huang

  9. University Hospital Eppendorf, Hamburg, Germany

    Nicolaus Kröger

  10. University Hospital Brno, Brno, Czech Republic

    Jiri Mayer

  11. Unit of Blood Diseases and Bone Marrow Transplantation, University of Brescia, ASST Spedali Civili, Brescia, Italy

    Domenico Russo

  12. Universitair Ziekenhuis Brussel, Brussels, Belgium

    Ann De Becker

  13. King Hussein Cancer Centre, Amman, Jordan

    Abdelghani Tbakhi

  14. Centre Henri Becquerel, Rouen, France

    Aspasia Stamatoullas

  15. University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany

    Thomas Valerius

  16. Department of Haematology, Trinity College Dublin, St. James’s Hospital, Dublin, Ireland

    Patrick Hayden

  17. Department of Haematology and Stem Cell Transplantation, University College London Hospitals NHS Trust, London, UK

    Donal P. McLornan

  18. Fondazione IRCCS - Ca’ Granda - Ospedale Maggiore Policlinico IRCCS, Milan, Italy

    Francesco Onida

  19. University of Cologne, Cologne, Germany

    Christof Scheid

  20. Hopital St. Louis, Paris, France

    Marie Robin

  21. CHU de Lille, Univ Lille, INSERM U1286, Infinite, 59000 Lille, Lille, France

    Ibrahim Yakoub-Agha

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  1. Joanna Drozd-Sokolowska
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  20. Marie Robin
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Contributions

JDS, LG, NK, MR, DL, NZ, and IYA were involved in study design, analysis and drafting the paper. All other co-authors contributed data to the study, critically revised the paper and approved the submitted and final version.

Corresponding author

Correspondence to Marie Robin.

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Drozd-Sokolowska, J., Gras, L., Zinger, N. et al. Allogeneic hematopoietic cell transplantation for myelodysplastic syndrome unclassifiable – a retrospective study on behalf of the Chronic Malignancies Working Party of the EBMT. Bone Marrow Transplant 58, 222–225 (2023). https://doi.org/10.1038/s41409-022-01870-9

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  • DOI: https://doi.org/10.1038/s41409-022-01870-9

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