Time to engraftment following allogeneic stem cell transplantation is significantly longer in patients with myelodysplastic syndrome than with acute myeloid leukemia

• Published in: Bone marrow transplantation (Basingstoke) Vol. 41; no. 1; pp. 69 - 78
• Main Authors: Bitan, M, Or, R, Shapira, M Y, Resnick, I B, Gesundheit, B, Ackerstein, A, Samuel, S, Elad, S, Slavin, S
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.01.2008; Nature Publishing Group
• Subjects: Adolescent; Adult; Aged; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Bone marrow; Bone marrow, stem cells transplantation. Graft versus host reaction; Care and treatment; Cell Biology; Child; Female; Hematologic and hematopoietic diseases; Hematology; Hematopoietic Stem Cell Transplantation; Humans; Internal Medicine; Leukemia, Myeloid, Acute - therapy; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Male; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Multivariate Analysis; Myelodysplastic syndromes; Myelodysplastic Syndromes - therapy; original-article; Patient outcomes; Public Health; Stem cell transplantation; Stem Cells; Time Factors; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Transplantation; Transplantation Conditioning; Transplantation, Homologous; AML; engraftment; SCT; myelodsplastic syndrome; Human; Acute myelogenous leukemia; Hematology; Stem cell; Hematopoietic cell; Homograft; Malignant hemopathy; Myelodysplastic syndrome; Engraftment; Graft; Cancer
• ISSN: 0268-3369; 1476-5365
• DOI: 10.1038/sj.bmt.1705878

Patients with myelodysplastic syndrome (MDS) commonly present with pancytopenia, suggesting that the marrow stroma fails to support the growth of both malignant and normal stem cells. We therefore retrospectively analyzed the duration to engraftment of neutrophils (⩾0.5 × 10 9 /l and ⩾1.0 × 10 9 /l) and platelets (⩾20 and ⩾50 × 10 9 /l) in 37 MDS patients and 42 patients suffering from primary AML, following allogeneic SCT. A significantly shorter time to engraftment was documented in AML as compared to MDS patients in all four parameters. These results held true even when we subgrouped the patients according to gender, age (50 years being the cutoff age between young and elderly patients), patient–donor relationship, donor match and intensity of conditioning. To the best of our knowledge, this is the first time that such a comparison has been made. We suggest that the longer duration of post transplant pancytopenia that is frequently observed in MDS patients may also influence post transplant outcome.