The bridge treatment selected at the decision for transplantation did not affect the outcomes in patients with MDS

Shinichi Kako, Yoshinobu Kanda, Jun Kato, Wataru Yamamoto, Seiko Kato, Makoto Onizuka, Akira Yokota, Raine Tatara, Hiroki Yokoyama, Maki Hagihara, Kensuke Usuki, Moritaka Gotoh, Reiko Watanabe, Nobutaka Kawai, Takayuki Saitoh, Heiwa Kanamori, Satoshi Takahashi, Shinichiro Okamoto

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2 Citations (Scopus)

Abstract

The optimal treatment for use as a bridge to allogeneic hematopoietic stem cell transplantation at the decision for transplantation has not been established in patients with myelodysplastic syndrome (MDS). We retrospectively evaluated the clinical outcomes after the decision for transplantation in our patients with MDS or acute myeloid leukemia (AML) secondary to MDS, aged more than 15 years, who underwent transplantation between 2007 and 2012. A total of 124 patients were included. We classified patients into two groups according to the bridge treatment selected at the decision for transplantation: Group 1, supportive care (n = 79), immunosuppressive therapy (n = 7), low-dose chemotherapy (n = 12); Group 2, AML-type induction chemotherapy (ICT: n = 22), azacitidine (Aza: n = 4). The rate of blasts in the bone marrow significantly influenced the treatment selection at the time of decision. There was no significant difference between the two groups in the rate of overall survival (OS) from the decision (73.1% vs 80.4% at 1 year) or from transplantation (59.0% vs 59.2% at 1 year). A significant difference was not observed even after patients were stratified according to either the rate of blasts in the bone marrow at the time of decision or the propensity score. In conclusion, the bridge treatment selected at the decision for transplantation did not affect the outcomes of transplantation in patients with MDS. However, this analysis did not include patients who could not undergo transplantation after the decision, and thus a prospective study is warranted.

Original languageEnglish
Pages (from-to)341-349
Number of pages9
JournalHematological Oncology
Volume35
Issue number3
DOIs
Publication statusPublished - 2017 Sep

Keywords

  • allogeneic transplantation
  • bridge treatment
  • chemotherapy
  • myelodysplastic syndrome
  • supportive care

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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  • Cite this

    Kako, S., Kanda, Y., Kato, J., Yamamoto, W., Kato, S., Onizuka, M., Yokota, A., Tatara, R., Yokoyama, H., Hagihara, M., Usuki, K., Gotoh, M., Watanabe, R., Kawai, N., Saitoh, T., Kanamori, H., Takahashi, S., & Okamoto, S. (2017). The bridge treatment selected at the decision for transplantation did not affect the outcomes in patients with MDS. Hematological Oncology, 35(3), 341-349. https://doi.org/10.1002/hon.2276