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Biol Blood Marrow Transplant. 2018 Mar;24(3):507-513. doi: 10.1016/j.bbmt.2017.11.017. Epub 2017 Nov 28.

Allogeneic Stem Cell Transplantation for Myelodysplastic Syndrome Patients with a 5q Deletion.

Author information

1
Department of Haematology, Hospital Saint Antoine, Paris, France. Electronic address: laurent.garderet@aphp.fr.
2
EBMT Data Office, Leiden University Medical Center, Leiden, The Netherlands.
3
EBMT Data Office Leiden, Leiden, The Netherlands.
4
Department of Medical Statistics, "Tor Vergata" University of Rome, Rome, Italy.
5
Department of Haematology, University of Freiburg, Freiburg, Germany.
6
Department of Haematology, University Hospital Gasthuisberg, Leuven, Belgium.
7
Department of Haematology, HUCH Comprehensive Cancer Center, Helsinki, Finland.
8
Department of Haematology, Karolinska University Hospital, Stockholm, Sweden.
9
Department of Haematology, CHU Nantes, Nantes, France.
10
Department of Haematology, University Hospital, Basel, Switzerland.
11
Department of Haematology, Radboud University-Nijmegen Medical Centre, Nijmegen, The Netherlands.
12
Department of Haematology, University Hospital, Essen, Germany.
13
Department of Haematology, Chaim Sheba Medical Center, Tel-Hashomer, Israel.
14
Department of Haematology, Centre de Recherche en Cancérologie de Marseille, Marseille, France.
15
Department of Haematology, Cliniques Universitaires St. Luc, Brussels, Belgium.
16
Department of Haematology, Hospital Huriez, Lille, France.
17
Department of Haematology, Skanes University Hospital, Lund, Sweden.
18
Department of Haematology, Centre for Clinical Haematology, Birmingham, UK.
19
Department of Haematology, Universitair Ziekenhuis Brussel, Brussels, Belgium.
20
Department of Haematology, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy.
21
Department of Haematology, University Hospital La Fe, University of Valencia, Valencia, Spain; Department of Haematology, Centro de Investigación Biomédica en Red de Cáncer, Instituto Carlos III, Madrid, Spain.
22
Department of Haematology, Charles University Hospital, Pilsen, Czech Republic.
23
Department of Haematology, GKT School of Medicine, London, UK.
24
Department of Haematology, Hospital St. Louis, Paris, France.
25
Department of Haematology, University Hospital Eppendorf, Hamburg, Germany.

Abstract

The deletion (5q) karyotype (del [5q]) in patients with myelodysplastic syndrome (MDS) is the most common karyotypic abnormality in de novo MDS. An increased number of blasts and additional karyotypic abnormalities (del [5q]+) are associated with a poor outcome. We analyzed the outcome of allogeneic hematopoietic cell transplants (HCT) in patients suffering from MDS with only del (5q) or del (5q)+ . A total of 162 patients, of median age 54 years (range, 9 to 73), having MDS and del (5q) abnormalities received HCT from identical siblings (n = 87) or unrelated donors (n = 75). The cumulative incidence of nonrelapse mortality and relapse incidence at 4 years was 29% (95% CI, 22 to 36) and 46% (95% CI, 38 to 54), whereas the estimated 4 year survival, relapse-free and overall, was 25% (95% CI, 18 to 33) and 30% (95% CI, 23 to 38), respectively. In a multivariate analysis patients with del (5q) and a blast excess displayed poorer survival (hazard ratio, 2.38; 95% CI, 1.44 to 3.93; P < .001), whereas female recipient sex resulted in improved survival (hazard ratio, .61; 95% CI, .41 to .90; P = .01). We conclude that allogeneic HCT can cure a subset of patients with MDS and a del (5q) abnormality.

KEYWORDS:

Allogeneic stem cell transplantation; MDS; del (5q)

PMID:
29196078
DOI:
10.1016/j.bbmt.2017.11.017

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