Preparing Patients With Myelodysplastic Syndrome for Transplant When Is Pre-transplant Cytoreductive Therapy Appropriate?

Wermke, Martin; Gloaguen, Silke; Platzbecker, Uwe

doi:10.1007/s11899-015-0276-z

Cited by 3 publications

(1 citation statement)

References 43 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…HMA could bring a significant benefit as a bridge to allo-HCT in patients with the TET2 mutation or a less aggressive disease, whereas aggressive chemotherapy is preferred for medically fit patients with an aggressive disease [ 19 , 20 ]. Wermke et al [ 21 ] suggested that up-front allo-HCT could be considered for patients with slowly progressing MDS if a donor is readily available.…”

Section: Discussionmentioning

confidence: 99%

No benefit of hypomethylating agents compared to supportive care for higher risk myelodysplastic syndrome

Sohn

Moon

Lee

et al. 2018

Korean J Intern Med

View full text Add to dashboard Cite

Background/AimsThis study evaluated the role of hypomethylating agents (HMA) compared to best supportive care (BSC) for patients with high or very-high (H/VH) risk myelodysplastic syndrome (MDS) according to the Revised International Prognostic Scoring System.MethodsA total of 279 H/VH risk MDS patients registered in the Korean MDS Working Party database were retrospectively analyzed.ResultsHMA therapy was administered to 205 patients (73.5%), including 31 patients (11.1%) who then received allogeneic hematopoietic cell transplantation (allo-HCT), while 74 patients (26.5%) received BSC or allo-HCT without HMA. The 3-year overall survival (OS) rates were 53.1% ± 10.7% for allo-HCT with HMA, 75% ± 21.7% for allo-HCT without HMA, 17.3% ± 3.6% for HMA, and 20.8% ± 6.9% for BSC groups (p < 0.001). In the multivariate analysis, only allo-HCT was related with favorable OS (hazard ratio [HR], 0.356; p = 0.002), while very poor cytogenetic risk (HR, 5.696; p = 0.042), age ≥ 65 years (HR, 1.578; p = 0.022), Eastern Cooperative Oncology Group performance status (ECOG PS) 2 to 4 (HR, 2.837; p < 0.001), and transformation to acute myeloid leukemia (AML) (HR, 1.901; p = 0.001) all had an adverse effect on OS.ConclusionsFor the H/VH risk group, very poor cytogenetic risk, age ≥ 65 years, ECOG PS 2 to 4, and AML transformation were poor prognostic factors. HMA showed no benefit in terms of OS when compared to BSC. Allo-HCT was the only factor predicting a favorable long-term outcome. The use of HMA therapy did not seem to have an adverse effect on the transplantation outcomes. However, the conclusion of this study should be carefully interpreted and proven by large scale research in the future.

show abstract

Section: Discussionmentioning

confidence: 99%

No benefit of hypomethylating agents compared to supportive care for higher risk myelodysplastic syndrome

Sohn

Moon

Lee

et al. 2018

Korean J Intern Med

View full text Add to dashboard Cite

show abstract

Long-term outcome of high risk patients with myelodysplastic syndromes or secondary acute myeloid leukemia receiving intensive chemotherapy

Schuler

Zadrozny

Blum³

et al. 2018

Ann Hematol

View full text Add to dashboard Cite

Intensive chemotherapy (IC) used to be a common treatment approach for patients with higher-risk myelodysplastic syndromes (MDS) or acute myeloid leukemia after MDS (sAML). We conducted a retrospective analysis of 299 patients, including a matched pair analysis comparing 96 patients receiving IC with 96 patients not undergoing IC, in order to evaluate the impact of IC on overall survival (OS) and to identify factors that influence remission rates and OS. Complete remission (CR) after first induction chemotherapy was reached in 50% of patients. Parameters influencing the probability of achieving CR were blast count in the bone marrow (< 30%), age < 65 years, presence of Auer rods, duration of antecedent MDS shorter than 6 months, and timing of IC in relation to first diagnosis. The difference in survival time was not significantly better for patients receiving IC (median OS 12.7 months vs. 7 months). Parameters favorably influencing survival were the presence of Auer rods, age below 60 years, blast count below 30%, IC given shortly after first diagnosis, and achievement of CR. On multivariate analysis, achieving CR, presence of Auer rods, and percentage of blasts below or above 30% significantly influenced median survival. Relapse occurred in 63% of patients after a median of 9.9 months with a median survival of 7.6 months. Considering the high relapse rate and short survival, we conclude that intensive chemotherapy is not promising for high-risk MDS or sAML.

show abstract

Allogeneic hematopoietic cell transplantation in patients with untreated acute myeloid leukemia: a KSGCT multicenter retrospective analysis

Tachibana

Ishizaki

Takahashi

et al. 2019

Bone Marrow Transplant

View full text Add to dashboard Cite

Preparing Patients With Myelodysplastic Syndrome for Transplant When Is Pre-transplant Cytoreductive Therapy Appropriate?

Cited by 3 publications

References 43 publications

No benefit of hypomethylating agents compared to supportive care for higher risk myelodysplastic syndrome

No benefit of hypomethylating agents compared to supportive care for higher risk myelodysplastic syndrome

Long-term outcome of high risk patients with myelodysplastic syndromes or secondary acute myeloid leukemia receiving intensive chemotherapy

Allogeneic hematopoietic cell transplantation in patients with untreated acute myeloid leukemia: a KSGCT multicenter retrospective analysis

Contact Info

Product

Resources

About