Hematopoietic Cell Transplantation in the Management of Myelodysplastic Syndrome: An Evidence-Based Review from the ASTCT Committee on Practice Guidelines

TY - JOUR

T1 - Hematopoietic Cell Transplantation in the Management of Myelodysplastic Syndrome: An Evidence-Based Review from the ASTCT Committee on Practice Guidelines

AU - DeFilipp, Zachariah

AU - Ciurea, Stefan O

AU - Cutler, Corey

AU - Robin, Marie

AU - Warlick, Erica D

AU - Nakamura, Ryotaro

AU - Brunner, Andrew M

AU - Dholaria, Bhagirathbhai

AU - Walker, Alison R

AU - Kroger, Nicolaus

AU - Bejanyan, Nelli

AU - Atallah, Ehab

AU - Tamari, Roni

AU - Solh, Melhem M

AU - Percival, Mary-Elizabeth

AU - de Lima, Marcos

AU - Scott, Bart

AU - Oran, Betul

AU - Garcia-Manero, Guillermo

AU - Hamadani, Mehdi

AU - Carpenter, Paul

AU - DeZern, Amy E

N1 - Copyright © 2022. Published by Elsevier Inc.

PY - 2023/2

Y1 - 2023/2

N2 - The sole curative therapy for myelodysplastic syndrome (MDS) is allogeneic hematopoietic cell transplantation (HCT). Here this therapeutic modality is reviewed and critically evaluated in the context of the evidence. Specific criteria were used for searching the published literature and for grading the quality and strength of the evidence and the strength of the recommendations. A panel of MDS experts comprising transplantation and nontransplantation physicians developed consensus treatment recommendations. This review summarizes the standard MDS indications for HCT and addresses areas of controversy. Recent prospective trials have confirmed that allogeneic HCT confers survival benefits in patients with advanced or high-risk MDS compared with nontransplantation approaches, and the use of HCT is increasing in older patients with good performance status. However, patients with high-risk cytogenetic or molecular mutations remain at high risk for relapse. It is unknown whether administration of novel therapies before or after transplantation may decrease the risk of disease relapse in selected populations. Ongoing and future studies will investigate revised approaches to disease risk stratification, patient selection, and post-transplantation approaches to optimize allogeneic HCT outcomes for patients with MDS.

AB - The sole curative therapy for myelodysplastic syndrome (MDS) is allogeneic hematopoietic cell transplantation (HCT). Here this therapeutic modality is reviewed and critically evaluated in the context of the evidence. Specific criteria were used for searching the published literature and for grading the quality and strength of the evidence and the strength of the recommendations. A panel of MDS experts comprising transplantation and nontransplantation physicians developed consensus treatment recommendations. This review summarizes the standard MDS indications for HCT and addresses areas of controversy. Recent prospective trials have confirmed that allogeneic HCT confers survival benefits in patients with advanced or high-risk MDS compared with nontransplantation approaches, and the use of HCT is increasing in older patients with good performance status. However, patients with high-risk cytogenetic or molecular mutations remain at high risk for relapse. It is unknown whether administration of novel therapies before or after transplantation may decrease the risk of disease relapse in selected populations. Ongoing and future studies will investigate revised approaches to disease risk stratification, patient selection, and post-transplantation approaches to optimize allogeneic HCT outcomes for patients with MDS.

KW - Aged

KW - Hematopoietic Stem Cell Transplantation

KW - Humans

KW - Myelodysplastic Syndromes/therapy

KW - Recurrence

KW - Transplantation Conditioning

KW - Transplantation, Homologous

KW - United States

U2 - 10.1016/j.jtct.2022.11.014

DO - 10.1016/j.jtct.2022.11.014

M3 - SCORING: Review article

C2 - 36436780

VL - 29

SP - 71

EP - 81

JO - TRANSPL CELL THER

JF - TRANSPL CELL THER

SN - 2666-6375

IS - 2

ER -