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Allogeneic Stem Cell Transplantation for Patients Age ≥ 70 Years with Myelodysplastic Syndrome: A Retrospective Study of the MDS Subcommittee of the Chronic Malignancies Working Party of the EBMT.

Abstract
In this retrospective analysis we evaluated the outcome of 313 patients aged ≥ 70 years in the registry of the European Group for Blood and Marrow Transplantation with myelodysplastic syndrome (MDS; n = 221) and secondary acute myeloid leukemia (n = 92) who underwent allogeneic hematopoietic stem cell transplantation (HSCT) from related (n = 79) or unrelated (n = 234) donors. Median age at HSCT was 72 years (range, 70 to 78). Conditioning regimen was nonmyeloablative (n = 54), reduced intensity (n = 207), or standard intensity (n = 52). Allogeneic HSCT for MDS patients ≥ 70 years was increasingly performed over time. Although during 2000 to 2004 only 16 patients received HSCT, during 2011 to 2013 the number of transplantations increased to 181. The cumulative incidence of nonrelapse mortality at 1 year and relapse at 3 years was 32% and 28%, respectively, with a 3-year overall survival rate of 34%. Good performance, determined by Karnofsky performance status, and recipients' seronegativity for cytomegalovirus was associated with 3-year estimated overall survival rates of 43% (P = .01) and 46% (P = .002), respectively. Conditioning intensity did not impact survival. After careful patient selection, allogeneic HSCT can be offered to patients older than 70 years with MDS.
AuthorsSilke Heidenreich, Dimitris Ziagkos, Liesbeth C de Wreede, Anja van Biezen, Jürgen Finke, Uwe Platzbecker, Dietger Niederwieser, Hermann Einsele, Wolfgang Bethge, Michael Schleuning, Dietrich W Beelen, Johanna Tischer, Arnon Nagler, Bertram Glass, Johan Maertens, Lucrecia Yáñez, Yves Beguin, Heinz Sill, Christof Scheid, Matthias Stelljes, Arnold Ganser, Pierre Zachée, Dominik Selleslag, Theo de Witte, Marie Robin, Nicolaus Kröger
JournalBiology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation (Biol Blood Marrow Transplant) Vol. 23 Issue 1 Pg. 44-52 (01 2017) ISSN: 1523-6536 [Electronic] United States
PMID27720995 (Publication Type: Journal Article)
CopyrightCopyright © 2017 The American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.
Topics
  • Aged
  • Cytomegalovirus (immunology)
  • Europe
  • Female
  • Hematopoietic Stem Cell Transplantation (methods, mortality)
  • Humans
  • Karnofsky Performance Status
  • Leukemia, Myeloid, Acute (mortality, therapy)
  • Male
  • Myelodysplastic Syndromes (mortality, therapy)
  • Recurrence
  • Registries
  • Retrospective Studies
  • Survival Analysis
  • Tissue Donors
  • Transplantation Conditioning (methods, mortality)
  • Transplantation, Homologous

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