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
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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. / Potter, V; Gras, L; Koster, L; Kroger, N; Sockel, K; Ganser, A; Finke, J; Labussiere-Wallet, H; Peffault de Latour, R; Koc, Y; Salmenniemi, U; Smidstrup Friis, L; Jindra, P; Schroeder, T; Tischer, J; Arat, M; Pascual Cascon, M; de Wreede, L C; Hayden, P; Raj, K; Drozd-Sokolowska, J; Scheid, C; McLornan, D P; Robin, M; Yakoub-Agha, I.
in: BONE MARROW TRANSPL, Jahrgang 59, Nr. 2, 02.2024, S. 224-231.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - 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
AU - Potter, V
AU - Gras, L
AU - Koster, L
AU - Kroger, N
AU - Sockel, K
AU - Ganser, A
AU - Finke, J
AU - Labussiere-Wallet, H
AU - Peffault de Latour, R
AU - Koc, Y
AU - Salmenniemi, U
AU - Smidstrup Friis, L
AU - Jindra, P
AU - Schroeder, T
AU - Tischer, J
AU - Arat, M
AU - Pascual Cascon, M
AU - de Wreede, L C
AU - Hayden, P
AU - Raj, K
AU - Drozd-Sokolowska, J
AU - Scheid, C
AU - McLornan, D P
AU - Robin, M
AU - Yakoub-Agha, I
N1 - © 2023. The Author(s), under exclusive licence to Springer Nature Limited.
PY - 2024/2
Y1 - 2024/2
N2 - 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.
AB - 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.
U2 - 10.1038/s41409-023-02111-3
DO - 10.1038/s41409-023-02111-3
M3 - SCORING: Journal article
C2 - 37993503
VL - 59
SP - 224
EP - 231
JO - BONE MARROW TRANSPL
JF - BONE MARROW TRANSPL
SN - 0268-3369
IS - 2
ER -