Allogeneic hematopoietic stem cell transplantation in adults with myelodysplastic syndrome: Experience of the Argentinean Group of Bone Marrow Transplantation (GATMO)

• Published in: Hematology (Luxembourg) Vol. 21; no. 3; p. 162
• Main Authors: Basquiera, Ana L, Rivas, María M, Remaggi, Guillermina, Klein, Graciela, Milovic, Vera, Foncuberta, M Cecilia, Saba, Silvia, Milone, Jorge H, Arbelbide, Jorge, Jaimovich, Gregorio, Rolón, Juliana Martínez, Kusminsky, Gustavo, García, Juan J, Prates, María V
• Format: Journal Article
• Language: English
• Published: England 15-03-2016
• Subjects: Adolescent; Adult; Aged; Allografts; Argentina - epidemiology; Disease-Free Survival; Female; Hematopoietic Stem Cell Transplantation; Humans; Male; Middle Aged; Myelodysplastic Syndromes - mortality; Myelodysplastic Syndromes - therapy; Retrospective Studies; Survival Rate; Stem cell transplantation; Relapse; Survival; Disease risk index; Unrelated donors; Myelodysplastic syndrome
• ISSN: 1607-8454
• DOI: 10.1179/1607845415Y.0000000028

Allogeneic hematopoietic stem cell transplantation (AHSCT) is a curative approach for patients with myelodysplastic syndrome (MDS).
In this multicenter retrospective study, we analyzed the outcome of adult patients with MDS who underwent AHSCT in Argentina and evaluated the prognostic factors associated with progression-free survival (PFS), overall survival (OS), cumulative incidence (CI) of relapse, and non-relapse mortality (NRM).
We analyzed data from 87 adults (median age: 43 years, range 18-66) who underwent SCT after myeloablative (n = 60) or non-myeloablative conditioning (n = 27), and from related (n = 62) or unrelated (n = 25) donors. For all patients, unadjusted 4-year PFS and OS were 37% and 38%, respectively; no significant differences were found between recipients of related or unrelated donors. One-year CI of relapse and NRM were 21% and 20%, respectively. In the multivariate analysis, intermediate disease risk index (DRI) and acute graft versus host disease AGVHD of all grades (I-IV) were independent variables associated with better PFS and lower relapse CI; only intermediate DRI was associated with better OS.
AHSCT is a feasible procedure in Argentina, with more than 30% of the patients achieving long-term survival. Recipients with unrelated donors had at least similar outcome than those with related donors. DRI may be useful to identify patients at higher risk of relapse after transplantation.