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Bone Marrow Transplant. 2017 Aug;52(8):1107-1112. doi: 10.1038/bmt.2017.19. Epub 2017 Mar 20.

Long-term follow-up of a retrospective comparison of reduced-intensity conditioning and conventional high-dose conditioning for allogeneic transplantation from matched related donors in myelodysplastic syndromes.

Author information

1
Hospital Santa Creu i Sant Pau, Barcelona, Spain.
2
EBMT Data Office, Leiden, The Netherlands.
3
Ospedale San Martino, Genova, Italy.
4
Radboud University-Nijmegen Medical Center, Nijmegen, The Netherlands.
5
University of Freiburg, Freiburg, Germany.
6
University Hospital, Essen, Germany.
7
Hôpital Haut-Leveque, Pessac, France.
8
Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
9
GKT School of Medicine, London, UK.
10
Leiden University Hospital, Leiden, The Netherlands.
11
A.O.U Citta della Salute e della Scienza di Torino, Torino, Italy.
12
CHU de Lille, CIRIC INSERM U995, Université de Lille 2, Lille, France.
13
HUCH Comprehensive Cancer Center, Helsinki, Finland.
14
University Hospital Gasthuisberg, Leuven, Belgium.
15
Hadassah University Hospital, Jerusalem, Israel.
16
Universite Paris IV, Hopital la Pitié-Salpêtrière, Paris, France.
17
Hospital Clinic, Barcelona, Spain.
18
Medizinische Universitaet Wien, Vienna, Austria.
19
Hospital de la Princesa, Madrid, Spain.
20
Institute of Hematology and Blood Transfusion, Prague, Czech Republic.
21
University Medical Center Mainz, Mainz, Germany.
22
Hopital St. Louis, Paris, France.
23
University Hospital Eppendorf, Hamburg, Germany.

Abstract

This study shows the long-term updated outcomes of a multicenter retrospective study which analyzed 843 patients with myelodysplastic syndrome (MDS) who underwent transplantation with an HLA-identical sibling donor with either reduced-intensity conditioning (RIC) in 213 patients, or standard myeloablative conditioning (MAC) in 630 patients. In multivariate analysis, the 13-year relapse rate was significantly increased after RIC (31% after MAC vs 48% in RIC; HR, 1.5; 95% CI, 1.1-1.9; P=0.04), but with no differences in overall survival (OS) (30% after MAC vs 27% in RIC; P=0.4) and PFS (29 vs 21%, respectively, P=0.3). Non-relapse mortality was higher in MAC (40 vs 31%; P=0.1), especially in patients older than 50 years (50 vs 33%, P<0.01). In addition, long-term follow-up confirms the importance of other variables on 13-year OS, mainly MDS risk category, disease phase, cytogenetics and receiving a high donor cell dose, irrespective of the conditioning regimen used.

PMID:
28319072
DOI:
10.1038/bmt.2017.19
[Indexed for MEDLINE]

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