Allogeneic hematopoietic stem cell transplantation for primary myelodysplastic syndrome

• Autor(a) principal: Medeiros,Carlos R.
• Data de Publicação: 2004
• Outros Autores: Gardin,Nilo E., Pasquini,Ricardo
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Revista brasileira de hematologia e hemoterapia (Online)
• Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-84842004000200002
• topic: Myelodysplastic syndrome; allogeneic hematopoietic stem cell transplantation; acute myeloid leukemia

Characteristics and outcomes of 52 patients with myelodysplastic syndrome (MDS) who underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT) were analyzed. Median age was 30 years (range 2-61 years) and median time from diagnosis to allo-HSCT was 10 months (range 1-161 months). Thirty-six patients had advanced MDS or acute myeloid leukemia following MDS at transplant. Conditioning with busulfan and cyclophosphamide was administered to 73% of patients, and the median value of graft dose was 2.595 x 10(8) of total nucleated cells/kg. Overall survival and disease free survival at 4 years were 36% and 33%, respectively. Nineteen patients were alive, with a median follow-up of 3.8 years. Twelve patients relapsed and only one is alive, after donor lymphocyte infusion. Interval < 6 months between diagnosis and allo-HSCT decreased relapse (P = 0.01). Mortality and relapse were significantly lower among patients with less advanced disease (P = 0.03). Decreased mortality was also observed when transplant occurred after 1994, probably because more patients with less advanced disease received the procedure. Acute GVHD grades > II occurred in 19 patients. Donor type (identical related versus non-related/partially matched related) influenced the incidence of acute GVHD (P = 0.03). Eleven patients developed chronic GVHD and previous acute GVHD was a risk factor (P = 0.03). Thirty-three patients died, 22 (67%) secondary to transplant-related complications. Patients with MDS should undergo allo-HSCT earlier, mainly if they have a compatible donor and are young.