Allogeneic Stem Cell Transplantation for Myelodysplastic Syndrome Patients with a 5q Deletion

• Published in: Biology of blood and marrow transplantation Vol. 24; no. 3; pp. 507 - 513
• Main Authors: Garderet, Laurent, Ziagkos, Dimitris, van Biezen, Anja, Iacobelli, Simona, Finke, Jürgen, Maertens, Johan, Volin, Liisa, Ljungman, Per, Chevallier, Patrice, Passweg, Jakob, Schaap, Nicolaas, Beelen, Dietrich, Nagler, Arnon, Blaise, Didier, Poiré, Xavier, Yakoub-Agha, Ibrahim, Lenhoff, Stig, Craddock, Charles, Schots, Rik, Rambaldi, Alessandro, Sanz, Jaime, Jindra, Pavel, Mufti, Ghulam J., Robin, Marie, Kröger, Nicolaus
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.03.2018
• Subjects: Allogeneic stem cell transplantation; del (5q); MDS; Medicin och hälsovetenskap; Allogeneic stem cell transplantation; MDS; del (5q)
• ISSN: 1083-8791; 1523-6536; 1523-6536
• DOI: 10.1016/j.bbmt.2017.11.017

•Outcome was studied of del 5q myelodysplastic syndrome patients undergoing allogeneic transplantation.•Patients with <5% bone marrow blasts and female recipients have the best prognosis.•Additional cytogenetic abnormalities do not influence the outcome. The deletion (5q) karyotype (del [5q]) in patients with myelodysplastic syndrome (MDS) is the most common karyotypic abnormality in de novo MDS. An increased number of blasts and additional karyotypic abnormalities (del [5q]+) are associated with a poor outcome. We analyzed the outcome of allogeneic hematopoietic cell transplants (HCT) in patients suffering from MDS with only del (5q) or del (5q)+ . A total of 162 patients, of median age 54 years (range, 9 to 73), having MDS and del (5q) abnormalities received HCT from identical siblings (n = 87) or unrelated donors (n = 75). The cumulative incidence of nonrelapse mortality and relapse incidence at 4 years was 29% (95% CI, 22 to 36) and 46% (95% CI, 38 to 54), whereas the estimated 4 year survival, relapse-free and overall, was 25% (95% CI, 18 to 33) and 30% (95% CI, 23 to 38), respectively. In a multivariate analysis patients with del (5q) and a blast excess displayed poorer survival (hazard ratio, 2.38; 95% CI, 1.44 to 3.93; P < .001), whereas female recipient sex resulted in improved survival (hazard ratio, .61; 95% CI, .41 to .90; P = .01). We conclude that allogeneic HCT can cure a subset of patients with MDS and a del (5q) abnormality.