Current status of pretransplant intensive chemotherapy or hypomethylating agents for myelodysplastic syndrome
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Current status of pretransplant intensive chemotherapy or hypomethylating agents for myelodysplastic syndrome. / Niederwieser, Christian; Kröger, Nicolaus.
in: BEST PRACT RES CL HA, Jahrgang 34, Nr. 4, 101332, 12.2021.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Review › Forschung
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TY - JOUR
T1 - Current status of pretransplant intensive chemotherapy or hypomethylating agents for myelodysplastic syndrome
AU - Niederwieser, Christian
AU - Kröger, Nicolaus
N1 - Copyright © 2021. Published by Elsevier Ltd.
PY - 2021/12
Y1 - 2021/12
N2 - Myelodysplastic syndrome is a heterogeneous disease with survival probabilities ranging from a few months to several years. Allogeneic hematopoietic cell transplantation (HCT) remains the only curative treatment. Although access (up to 75 years) and outcome of HCT have improved steadily in recent years, high relapse rates and, to a lower extent, treatment related mortalities are a persisting problem. Reduction of tumor burden before HCT has been shown to decrease relapse incidence and often overall survival (OS) in hematological malignancies but the role of pretransplant therapy in MDS remains controversial. We reviewed the role of pretransplant therapy on outcome in MDS patients. No prospective randomized trial addressed this issue so far. Retrospective studies have shown that pretransplant therapy reduces the risk of relapse, but does not improve survival. In addition, registry studies from diagnosis with standard protocols are proposed in order to exclude patient selection. With the availability of new, more effective and low-toxicity therapies, it may be possible to achieve a significant improvement of OS in the future.
AB - Myelodysplastic syndrome is a heterogeneous disease with survival probabilities ranging from a few months to several years. Allogeneic hematopoietic cell transplantation (HCT) remains the only curative treatment. Although access (up to 75 years) and outcome of HCT have improved steadily in recent years, high relapse rates and, to a lower extent, treatment related mortalities are a persisting problem. Reduction of tumor burden before HCT has been shown to decrease relapse incidence and often overall survival (OS) in hematological malignancies but the role of pretransplant therapy in MDS remains controversial. We reviewed the role of pretransplant therapy on outcome in MDS patients. No prospective randomized trial addressed this issue so far. Retrospective studies have shown that pretransplant therapy reduces the risk of relapse, but does not improve survival. In addition, registry studies from diagnosis with standard protocols are proposed in order to exclude patient selection. With the availability of new, more effective and low-toxicity therapies, it may be possible to achieve a significant improvement of OS in the future.
KW - Hematopoietic Stem Cell Transplantation
KW - Humans
KW - Myelodysplastic Syndromes/drug therapy
KW - Neoplasm Recurrence, Local
KW - Retrospective Studies
U2 - 10.1016/j.beha.2021.101332
DO - 10.1016/j.beha.2021.101332
M3 - SCORING: Review article
C2 - 34865704
VL - 34
JO - BEST PRACT RES CL HA
JF - BEST PRACT RES CL HA
SN - 1521-6926
IS - 4
M1 - 101332
ER -