Title :

Sequential vs myeloablative vs reduced intensity conditioning for patients with myelodysplastic syndromes with an excess of blasts at time of allogeneic haematopoietic cell transplantation: a retrospective study by the chronic malignancies working party of the EBMT.

Author(s) :

Potter, V. [Auteur]
King's College Hospital [KCH]
Gras, L. [Auteur]
Universiteit Leiden = Leiden University
Koster, L. [Auteur]
Universiteit Leiden = Leiden University
Kroger, N. [Auteur]
University Hospital Hamburg-Eppendorf
Sockel, K. [Auteur]
Dresden University of Applied Sciences
Ganser, A. [Auteur]
Medizinische Hochschule Hannover = Hannover Medical School [MHH]
Finke, J. [Auteur]

Labussiere-Wallet, H. [Auteur]
Centre Hospitalier Lyon Sud [CHU - HCL] [CHLS]
Peffault De Latour, R. [Auteur]
Hopital Saint-Louis [AP-HP] [AP-HP]
Koc, Y. [Auteur]
Salmenniemi, U. [Auteur]
Smidstrup Friis, L. [Auteur]
Jindra, P. [Auteur]
Schroeder, T. [Auteur]
University Hospital Essen [AöR]
Tischer, J. [Auteur]
University-Hospital Munich-Großhadern [München]
Arat, M. [Auteur]
Avrasya Yer Bilimleri Enstitüsü = Eurasia Institute of Earth Sciences [Istanbul] [AYBE]
Pascual Cascon, M. [Auteur]
Hospital Regional Universitario de Málaga = Regional University Hospital of Malaga [Spain]
De Wreede, L. C. [Auteur]
Leiden University Medical Center [LUMC]
Hayden, P. [Auteur]
Trinity College Dublin
Raj, K. [Auteur]
University College London Hospitals [UCLH]
Drozd-Sokolowska, J. [Auteur]
Medical University of Warsaw - Poland
Scheid, C. [Auteur]
University of Cologne
Mclornan, D. P. [Auteur]
University College London Hospitals [UCLH]
Robin, M. [Auteur]
Hopital Saint-Louis [AP-HP] [AP-HP]
Yakoub-Agha, Ibrahim [Auteur]
Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286

Journal title :

Bone Marrow Transplantation

Abbreviated title :

Bone Marrow Transplant

Publication date :

2023-11-24

ISSN :

1476-5365

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

The optimal conditioning for patients with higher risk MDS receiving potentially curative allogeneic haematopoietic stem cell transplant(allo-HCT) remains to be defined. This is particularly the case for patients with ...
Show more >The optimal conditioning for patients with higher risk MDS receiving potentially curative allogeneic haematopoietic stem cell transplant(allo-HCT) remains to be defined. This is particularly the case for patients with excess of blasts at time of allo-HCT. Sequential (Seq) conditioning, whereby chemotherapy is followed rapidly by transplant conditioning, offers an opportunity to decrease disease burden, potentially improving outcomes allo-HCT outcomes. Herein we present the only analysis comparing Seq to myeloablative (MAC) and reduced intensity conditioning (RIC) specifically focussed on MDS patients with excess of blasts at allo-HCT. 303 patients were identified in the EBMT registry, receiving RIC (n = 158), Seq (n = 105), and MAC (n = 40). Median follow-up was 67.2 months and median age at allo-HCT was 59.5 years (IQR 53.5–65.6). For the entire cohort, 3 y overall survival (OS) was 50% (95% CI 45–56%) and relapse free survival (RFS) 45% (95% CI 40–51%). No significant differences in OS (log-rank p = 0.13) and RFS (log-rank p = 0.18) were observed between conditioning protocols. On multivariable analysis, lower performance status, worse IPSS-R cytogenetics, sibling donor (compared to 8/8 MUD) and ≥20% blasts at allo-HCT were associated with worse outcomes. In conclusion, the Seq protocol did little to influence the outcome in this high-risk group of patients, with outcomes mostly determined by baseline disease risk and patient characteristics such as performance status.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Université de Lille
Inserm
CHU Lille

Collections :

• Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286

Submission date :

2024-02-06T22:20:21Z
2024-03-20T09:28:21Z