Haploidentical Hematopoietic Stem Cell Transplantation for Myelodysplastic Syndrome

Abstract

This study aimed to validate the capability of the Center for International Blood and Marrow Transplant Research (CIBMTR) prognostic scoring system to predict outcomes of patients with myelodysplastic syndromes (MDS) who had undergone HLA-haploidentical related donor hematopoietic stem cell transplantation (haplo-HSCT). We also propose and validate a more suitable prognostic scoring system. A total of 157 patients with MDS who underwent haplo-HSCT were enrolled. The CIBMTR prognostic scoring system could predict the 2-year clinical outcomes, but failed to predict the 100-day clinical outcomes after haplo-HSCT. Our multivariable model identified 2 independent predictors of overall survival: age and monosomal karyotype (MK). Weighted scores of 5, 3, and 2 were assigned to age ≥50 years, age 30 to 49 years, and MK, respectively, and a 2-category system was created: low (score ≤3) and high (score >3). Our refined prognostic scoring system can predict both the 100-day and 2-year clinical outcomes after haplo-HSCT. Our findings indicate that the CIBMTR prognostic scoring system is predictive of the outcomes of patients with MDS following haplo-HSCT, and that older patients with MDS and/or patients with MK should be closely monitored after haplo-HSCT.

Comparison of transplant‐specific prognostic scoring systems in haploidentical transplantation for myelodysplastic syndrome

“…In addition, a recently published report with larger cohort of MDS recipients receiving haploidentical SCT showed that the CIBMTR scoring system was a useful tool to predict post-transplant outcomes. 25 The predictability of the CIBMTR scoring system for patients with MDS who received haploidentical SCT remains yet to be confirmed in further studies.…”

Prognostic significance of monosomal karyotype in myelodysplastic syndrome: a meta-analysis

“…After carefully reading the full texts, 13 studies were excluded due to insufficient data. Finally, 17 studies, [8][9][10][11][12][13][14][15][16][17][18][19][20][25][26][27][28] including a letter to the editor [18] were included in this meta-analysis.…”

“…The study conducted by Xing et al [9] included 610 patients, however, followup data were only available in 390 patients who received nonintensive therapies and extracted for this meta-analysis. Of the 17 eligible studies, 5 studies were from North America, [17,[25][26][27][28] 5 from Europe, [13,14,[16][17][18] 6 from Asia, [9,11,12,15,19,20] 1 from Oceania [10]. The median age in 6 studies was over 60 years, [10,[13][14][15]17,19] in 7 studies under 60 years, [11,12,16,20,[25][26][27] and in 4 studies not available [8,9,18,28].…”

“…Of the 17 eligible studies, 5 studies were from North America, [17,[25][26][27][28] 5 from Europe, [13,14,[16][17][18] 6 from Asia, [9,11,12,15,19,20] 1 from Oceania [10]. The median age in 6 studies was over 60 years, [10,[13][14][15]17,19] in 7 studies under 60 years, [11,12,16,20,[25][26][27] and in 4 studies not available [8,9,18,28]. In 10 studies patients were classified by WHO criteria, [9,10,15,17,19,25,27] in 1 study by FAB criteria, [28] in 5 studies by both WHO and FAB criteria, [8,13,16,20,26] but classification criteria were not available in 1 study [18].…”

“…However, its prognostic role in MDS has still remained controversial. Several studies indicated that MK served as an independent negative predictor of overall survival (OS) in MDS [8][9][10][11][12]. But in the study conducted by Schanz et al [13] MK was associated with inferior OS in patients with ≤4 abnormalities only, not in highly complex karyotypes (≥5 abnormalities).…”