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01-06-2019 | Myelodysplastic Syndrome | Original Article

Increased opportunity for prolonged survival after allogeneic hematopoietic stem cell transplantation in patients aged 60–69 years with myelodysplastic syndrome

Authors: Hidehiro Itonaga, Ken Ishiyama, Kazunari Aoki, Jun Aoki, Takayuki Ishikawa, Naoyuki Uchida, Kazuteru Ohashi, Yasunori Ueda, Takahiro Fukuda, Toru Sakura, Yuju Ohno, Koji Iwato, Hirokazu Okumura, Tadakazu Kondo, Tatsuo Ichinohe, Minoko Takanashi, Yoshiko Atsuta, Yasushi Miyazaki

Published in: Annals of Hematology | Issue 6/2019

Abstract

We conducted a nationwide retrospective study to evaluate the outcomes of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in 651 patients aged 60–69 years with de novo myelodysplastic syndrome (MDS). We divided patients into two groups: 152 and 499 patients with an early and advanced disease status, respectively. The 3-year overall survival (OS) rate of patients with an early disease status was 45.9% (95% confidence interval [CI], 37.0 to 54.2%). A multivariate analysis revealed five adverse factors for OS: performance status (PS) 2–4 (hazard ratio [HR] 4.48; P < .001), poor cytogenetic risk group (HR 1.83; P = .041), male recipient (HR 2.58; P = .003), use of HLA-mismatched related grafts (HR 4.75; P = .003), and unrelated cord blood (HR 2.47; P = .023). The 3-year OS rate of patients with an advanced disease status was 37.2% (95% CI 32.4 to 41.9%). Five factors correlated with worse OS: PS 2–4 (HR 1.72; P = .003), poor cytogenetic risk group (HR 1.49; P = .003), use of HLA-mismatched related grafts (HR 1.96; P = .015), unrelated cord blood (HR 2.05; P < .001), and the high number of red blood cell transfusions before transplantation (HR 1.85; P = .018). The present results revealed the more frequent utilization of allo-HSCT for MDS patients aged 60–69 years, which increases the curative potential.

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Title: Increased opportunity for prolonged survival after allogeneic hematopoietic stem cell transplantation in patients aged 60–69 years with myelodysplastic syndrome
Authors: Hidehiro Itonaga
Ken Ishiyama
Kazunari Aoki
Jun Aoki
Takayuki Ishikawa
Naoyuki Uchida
Kazuteru Ohashi
Yasunori Ueda
Takahiro Fukuda
Toru Sakura
Yuju Ohno
Koji Iwato
Hirokazu Okumura
Tadakazu Kondo
Tatsuo Ichinohe
Minoko Takanashi
Yoshiko Atsuta
Yasushi Miyazaki
Publication date: 01-06-2019
Publisher: Springer Berlin Heidelberg
Keywords: Myelodysplastic Syndrome
Graft-Versus-Host Disease
Graft-Versus-Host Disease
Stem Cell Transplantation
Stem Cell Transplantion
Stem Cell Transplantation
Published in: Annals of Hematology / Issue 6/2019
Print ISSN: 0939-5555
Electronic ISSN: 1432-0584
DOI: https://doi.org/10.1007/s00277-019-03653-7

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Increased opportunity for prolonged survival after allogeneic hematopoietic stem cell transplantation in patients aged 60–69 years with myelodysplastic syndrome

Abstract

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Abstract

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