Outcomes of 138 myelodysplastic syndrome patients with HLA-matched sibling donor allogeneic hematopoietic stem cell transplantation.
10.3760/cma.j.issn.0253-2727.2020.02.009
- Author:
Qian Qian WANG
1
;
Zi Xian LIU
;
Xiao Li ZHAO
;
Gui Xin ZHANG
;
Jian Feng YAO
;
Xiao Hui ZHENG
;
Li Ning ZHANG
;
Yu Yan SHEN
;
Xing Li ZHAO
;
Yi HE
;
Yong HUANG
;
Rong Li ZHANG
;
Jia Lin WEI
;
Qiao Ling MA
;
Ai Ming PANG
;
Dong Lin YANG
;
Wei Hua ZHAI
;
Er Lie JIANG
;
Si Zhou FENG
;
Ming Zhe HAN
Author Information
1. Institute of Hematology & Blood Diseases Hospital, CAMS & PUMC, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Tianjin 300020, China.
- Publication Type:Journal Article
- Keywords:
Hematopoietic stem cell transplantation;
Myelodysplastic syndromes;
Prognostic factors;
Sibling donor
- MeSH:
Graft vs Host Disease;
Hematopoietic Stem Cell Transplantation;
Humans;
Leukemia, Myeloid, Acute;
Myelodysplastic Syndromes;
Retrospective Studies;
Siblings;
Transplantation Conditioning;
Transplantation, Homologous
- From:
Chinese Journal of Hematology
2020;41(2):132-137
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To evaluate the outcomes of myelodysplastic syndromes (MDS) patients who received HLA-matched sibling donor allogeneic peripheral blood stem cell transplantation (MSD-PBSCT) . Methods: The clinical data of 138 MDS patients received MSD-PBSCT from Sep. 2005 to Dec. 2017 were retrospectively analyzed, and the overall survival (OS) rate, disease-free survival (DFS) rate, relapse rate (RR) , non-relapse mortality (NRM) rate and the related risk factors were explored. Results: ①After a median follow-up of 1 050 (range 4 to 4 988) days, the 3-year OS and DFS rates were (66.6±4.1) % and (63.3±4.1) %, respectively. The 3-year cumulative incidence of RR and NRM rates were (13.9±0.1) % and (22.2±0.1) %, respectively. ②Univariate analysis showed that patients with grade Ⅲ-Ⅳ acute graft-versus-host disease (aGVHD) or hematopoietic cell transplantation comorbidity index (HCT-CI) ≥2 points or patients in very high-risk group of the Revised International Prognostic Scoring System (IPSS-R) had significantly decreased OS[ (42.9±13.2) %vs (72.9±4.2) %, χ(2)=8.620, P=0.003; (53.3±7.6) %vs (72.6±4.7) %, χ(2)=6.681, P=0.010; (53.8±6.8) %vs (76.6±6.2) %vs (73.3±7.7) %, χ(2)=6.337, P=0.042]. For MDS patients with excess blasts-2 (MDS-EB2) and acute myeloid leukemia patients derived from MDS (MDS-AML) , pre-transplant chemotherapy or hypomethylating agents (HMA) therapy could not improve the OS rate[ (60.4±7.8) %vs (59.2±9.6) %, χ(2)=0.042, P=0.838]. ③Multivariate analysis indicated that the HCT-CI was an independent risk factor for OS and DFS (P=0.012, HR=2.108, 95%CI 1.174-3.785; P=0.008, HR=2.128, 95%CI 1.219-3.712) . Conclusions: HCT-CI was better than the IPSS-R in predicting the outcomes after transplantation. The occurrence of grade Ⅲ-Ⅳ aGVHD is a poor prognostic factor for OS. For patients of MDS-EB2 and MDS-AML, immediate transplantation was recommended instead of receiving pre-transplant chemotherapy or HMA therapy.
