Sequential vs myeloablative vs reduced intensity conditioning for patients with myelodysplastic syndromes with an excess of blasts at time of allogeneic haematopoietic cell transplantation: a retrospective study by the chronic malignancies working party of the EBMT

Publikation: Beitrag in FachzeitschriftForschungsartikelBeigetragenBegutachtung

Beitragende

  • V Potter - , Kings College Hospital NHS Foundation Trust (Autor:in)
  • L Gras - , EBMT Statistical Unit (Autor:in)
  • L Koster - , EBMT Leiden Study Unit (Autor:in)
  • N Kroger - , Universitätsklinikum Hamburg-Eppendorf (UKE) (Autor:in)
  • K Sockel - , Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus Dresden (Autor:in)
  • A Ganser - , Medizinische Hochschule Hannover (MHH) (Autor:in)
  • J Finke - , Evangelische Hochschule Freiburg (Autor:in)
  • H Labussiere-Wallet - , Hospices civils de Lyon (Autor:in)
  • R Peffault de Latour - , Hôpital Saint-Louis AP-HP (Autor:in)
  • Y Koc - , Medicana International Hospital Istanbul (Autor:in)
  • U Salmenniemi - , HUCH Comprehensive Cancer Center (Autor:in)
  • L Smidstrup Friis - , Bone Marrow Transplant Unit L 4043 (Autor:in)
  • P Jindra - , Universitätskrankenhaus Motol (Autor:in)
  • T Schroeder - , LVR-Universitätsklinik Essen (Autor:in)
  • J Tischer - , Klinikum Grosshadern (Autor:in)
  • M Arat - , İstanbul Florence Nightingale Hospital (Autor:in)
  • M Pascual Cascon - , Hospital Regional de Málaga (Autor:in)
  • L C de Wreede - , Leiden University (Autor:in)
  • P Hayden - , Trinity College Dublin (Autor:in)
  • K Raj - , University College London Hospitals NHS Foundation Trust (Autor:in)
  • J Drozd-Sokolowska - , Medical University of Warsaw (Autor:in)
  • C Scheid - , Universitätsklinikum Köln (Autor:in)
  • D P McLornan - , University College London Hospitals NHS Foundation Trust (Autor:in)
  • M Robin - , Hôpital Saint-Louis AP-HP (Autor:in)
  • I Yakoub-Agha - , CHU de Lille (Autor:in)

Abstract

The optimal conditioning for patients with higher risk MDS receiving potentially curative allogeneic haematopoietic stem cell transplant(allo-HCT) remains to be defined. This is particularly the case for patients with excess of blasts at time of allo-HCT. Sequential (Seq) conditioning, whereby chemotherapy is followed rapidly by transplant conditioning, offers an opportunity to decrease disease burden, potentially improving outcomes allo-HCT outcomes. Herein we present the only analysis comparing Seq to myeloablative (MAC) and reduced intensity conditioning (RIC) specifically focussed on MDS patients with excess of blasts at allo-HCT. 303 patients were identified in the EBMT registry, receiving RIC (n = 158), Seq (n = 105), and MAC (n = 40). Median follow-up was 67.2 months and median age at allo-HCT was 59.5 years (IQR 53.5-65.6). For the entire cohort, 3 y overall survival (OS) was 50% (95% CI 45-56%) and relapse free survival (RFS) 45% (95% CI 40-51%). No significant differences in OS (log-rank p = 0.13) and RFS (log-rank p = 0.18) were observed between conditioning protocols. On multivariable analysis, lower performance status, worse IPSS-R cytogenetics, sibling donor (compared to 8/8 MUD) and ≥20% blasts at allo-HCT were associated with worse outcomes. In conclusion, the Seq protocol did little to influence the outcome in this high-risk group of patients, with outcomes mostly determined by baseline disease risk and patient characteristics such as performance status.

Details

OriginalspracheEnglisch
FachzeitschriftBone marrow transplantation
PublikationsstatusElektronische Veröffentlichung vor Drucklegung - 22 Nov. 2023
Peer-Review-StatusJa

Externe IDs

Scopus 85177460879

Schlagworte