Publication Date:
2011-11-18
Description:
Abstract 2033 Background: As patients with myelodysplastic syndrome (MDS) tend to be older and to have more comorbidities, reduced-intensity conditioning (RIC) has been more frequently used in allogeneic hematopietic cell transplantation (HCT) for patients with MDS. Although alloimmune effect by donor T-cells is important to control disease especially after HCT using RIC, significance of this effect has not been fully evaluated in patients with MDS. Patients and Methods: We retrospectively reviewed medical records of 115 patients with de novo MDS or acute myeloid leukemia with multilineage dysplasia (AML-MLD) who underwent first allogeneic HCT at our center between 2000 and 2009.Patients with therapy-related MDS and cord blood transplant recipients were excluded. Karyotypic risk group was stratified according to the International Prognostic Scoring System (IPSS). Results: The median age of the patients was 55 yrs (range, 19–68). The median follow-up of surviving patients was 40 months (8–130). FAB classification at diagnosis included RA/RARS (n=45), RAEB (40), CMMoL (4), RAEB-T (12), and AML-MLD (14). Karyotype at diagnosis was good-risk in 45 patients, intermediate-risk in 30, and poor-risk in 40. The IPSS risk at diagnosis was Low in 4 patients, Int-1 in 33, Int-2 in 44, and High in 20. Among the 115 patients with MDS or AML-MLD, 68 (59%) received chemotherapy before HCT. Blast count at HCT was less than 5% in 60 patients, 5–19% in 38 patients, 20% or more in 10 patients, and not evaluable in 7 patients. Fifty-five patients received grafts from a related donor (BM 3, PBSC 52), and 60 patients received BM grafts from an unrelated donor. Conditioning regimens included myeloablative (MAC, n=34) and RIC (n=81). Among the 81 RIC recipients, 23 received low-dose TBI and 26 received ATG. The patients who received RIC were significantly older (median, 57 yrs vs. 46 yrs, p20%, HR 3.74, 95%CI 1.73–8.08, p
Print ISSN:
0006-4971
Electronic ISSN:
1528-0020
Topics:
Biology
,
Medicine
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