Prognostic pre-transplant factors in myelodysplastic syndromes primarily treated by high dose allogeneic hematopoietic stem cell transplantation: a retrospective study of the MDS subcommittee of the CMWP of the EBMT
Standard
Prognostic pre-transplant factors in myelodysplastic syndromes primarily treated by high dose allogeneic hematopoietic stem cell transplantation: a retrospective study of the MDS subcommittee of the CMWP of the EBMT. / Cremers, E M P; van Biezen, A; de Wreede, L C; Scholten, M; Vitek, A; Finke, J; Platzbecker, U; Beelen, D; Schwerdtfeger, R; Volin, L; Harhalakis, N; Blijlevens, N; Nagler, A; Kröger, N; de Witte, T.
In: ANN HEMATOL, Vol. 95, No. 12, 12.2016, p. 1971-1978.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Prognostic pre-transplant factors in myelodysplastic syndromes primarily treated by high dose allogeneic hematopoietic stem cell transplantation: a retrospective study of the MDS subcommittee of the CMWP of the EBMT
AU - Cremers, E M P
AU - van Biezen, A
AU - de Wreede, L C
AU - Scholten, M
AU - Vitek, A
AU - Finke, J
AU - Platzbecker, U
AU - Beelen, D
AU - Schwerdtfeger, R
AU - Volin, L
AU - Harhalakis, N
AU - Blijlevens, N
AU - Nagler, A
AU - Kröger, N
AU - de Witte, T
PY - 2016/12
Y1 - 2016/12
N2 - Many pre-transplant factors are known to influence the outcome of allogeneic stem cell transplantation (SCT) treatment in myelodysplastic syndromes (MDS). However, patient cohorts are often heterogeneous by disease stage and treatment modalities, which complicates interpretation of the results. This study aimed to obtain a homogeneous patient cohort by including only de novo MDS patients who received upfront allogeneic SCT after standard high dose myelo-ablative conditioning. The effect of pre-transplant factors such as age, disease stage, transfusions, iron parameters and comorbidity on overall survival (OS), non-relapse mortality (NRM), and relapse incidence (RI) was evaluated in 201 patients. In this cohort, characterized by low comorbidity and a short interval between diagnosis and transplantation, NRM was the most determinant factor for survival after SCT (47 % after 2-year follow-up). WHO classification and transfusion burden were the only modalities with a significant impact on overall survival after SCT. Estimated hazard ratios (HR) showed a strongly increased risk of death, NRM and RI, in patients with a high transfusion-burden (HR 1.99; P = 0.006, HR of 1.89; P = 0.03 and HR 2.67; P = 0.03). The HR's for ferritin level and comorbidity were not significantly increased.
AB - Many pre-transplant factors are known to influence the outcome of allogeneic stem cell transplantation (SCT) treatment in myelodysplastic syndromes (MDS). However, patient cohorts are often heterogeneous by disease stage and treatment modalities, which complicates interpretation of the results. This study aimed to obtain a homogeneous patient cohort by including only de novo MDS patients who received upfront allogeneic SCT after standard high dose myelo-ablative conditioning. The effect of pre-transplant factors such as age, disease stage, transfusions, iron parameters and comorbidity on overall survival (OS), non-relapse mortality (NRM), and relapse incidence (RI) was evaluated in 201 patients. In this cohort, characterized by low comorbidity and a short interval between diagnosis and transplantation, NRM was the most determinant factor for survival after SCT (47 % after 2-year follow-up). WHO classification and transfusion burden were the only modalities with a significant impact on overall survival after SCT. Estimated hazard ratios (HR) showed a strongly increased risk of death, NRM and RI, in patients with a high transfusion-burden (HR 1.99; P = 0.006, HR of 1.89; P = 0.03 and HR 2.67; P = 0.03). The HR's for ferritin level and comorbidity were not significantly increased.
KW - Adolescent
KW - Adult
KW - Aged
KW - Europe
KW - Female
KW - Hematopoietic Stem Cell Transplantation
KW - Humans
KW - Male
KW - Middle Aged
KW - Mortality
KW - Myelodysplastic Syndromes
KW - Prognosis
KW - Retrospective Studies
KW - Transplantation, Homologous
KW - Treatment Outcome
KW - Young Adult
KW - Journal Article
U2 - 10.1007/s00277-016-2802-z
DO - 10.1007/s00277-016-2802-z
M3 - SCORING: Journal article
C2 - 27650829
VL - 95
SP - 1971
EP - 1978
JO - ANN HEMATOL
JF - ANN HEMATOL
SN - 0939-5555
IS - 12
ER -