Progress in survival following three decades of allogeneic hematopoietic cell transplantation for myelodysplastic syndrome: A real‐world registry study in Japan

Konuma, Takaaki; Itonaga, Hidehiro; Ishiyama, Ken; Hamamura, Atsushi; Uchida, Naoyuki; Ozawa, Yukiyasu; Katayama, Yuta; Sakurai, Masatoshi; Ueda, Yasunori; Matsuoka, Ken‐ichi; Kawakita, Toshiro; Eto, Tetsuya; Ara, Takahide; Kanda, Junya; Onizuka, Makoto; Fukuda, Takahiro; Atsuta, Yoshiko

doi:10.1002/ajh.26839

Cited by 11 publications

(1 citation statement)

References 16 publications

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“…Unrelated cord blood (UCB) is an alternative donor option for adult patients with MDS who require prompt allogeneic HCT without an MSD or matched unrelated donor (MUD). [3][4][5][6][7][8][9][10][11][12] The advancement of UCB transplantation (CBT) procedures has contributed to the recent improvement in engraftment and early mortality, 13 which were the main limitations of CBT in adults. These improvements have resulted in a drastic expansion of CBT for MDS in recent years.…”

Section: Introductionmentioning

confidence: 99%

Single‐unit unrelated cord blood transplantation versus HLA‐matched sibling transplantation in adults with advanced myelodysplastic syndrome: A registry‐based study from the adult MDS working group of the Japanese society for transplantation and cellular therapy

Konuma,

Itonaga,

Shimomura

et al. 2023

Hematological Oncology

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Allogeneic hematopoietic stem cell transplantation (HCT) remains the only potential curative therapeutic modality for advanced myelodysplastic syndrome (MDS). Within HCT, the advancement of cord blood transplantation (CBT) procedures has resulted in a drastic expansion of CBT as a donor source for MDS. However, data comparing matched sibling donors (MSDs) HCT with CBT for advanced MDS, which was defined as refractory anemia with an excess of blasts (RAEB)‐1 and RAEB‐2 according to the World Health Organization classification at the time of HCT, have not been explored. We retrospectively compared survival and other posttransplant outcomes in 999 adult patients with advanced MDS after receiving allogeneic HCT in Japan between 2011 and 2020, using either MSD (n = 331) or single‐unit unrelated cord blood (UCB) (n = 668). In the multivariate analysis, there were no significant differences in overall survival (hazard ratio [HR], 1.10; 95% confidence interval [CI], 0.90–1.34; P = 0.347), disease‐free survival (HR, 1.01; 95% CI, 0.84–1.23; P = 0.845), relapse (HR, 0.88; 95% CI, 0.68–1.15; P = 0.370), or non‐relapse mortality (HR, 1.15; 95% CI, 0.87–1.50; P = 0.310) between MSD recipients and UCB recipients. UCB was significantly associated with lower neutrophil (HR, 0.28; 95% CI, 0.24–0.33; P < 0.001) and lower platelet (HR, 0.29; 95% CI, 0.23–0.36; P < 0.001) recovery compared to MSD. UCB was significantly associated with a lower incidence of chronic graft‐versus‐host disease (GVHD) (HR, 0.57; 95% CI, 0.44–0.75; P < 0.001) and extensive chronic GVHD (HR, 0.46; 95% CI, 0.32–0.67; P < 0.001) compared to MSD. Similar results were observed after adjusting for differences between MSD and UCB recipients by propensity score matching analysis. Our study demonstrated that single CBT and MSD HCT had similar survival outcomes for adult patients with advanced MDS despite the lower hematopoietic recovery in CBT recipients and higher chronic GVHD in MSD recipients.

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