Value of chemotherapy before allogeneic hematopoietic stem cell transplantation from an HLA-identical sibling donor for myelodysplastic syndrome

K. Nakai, Y. Kanda, S. Fukuhara, H. Sakamaki, S. Okamoto, Y. Kodera, R. Tanosaki, S. Takahashi, T. Matsushima, Y. Atsuta, N. Hamajima, M. Kasai, S. Kato

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Abstract

Allogeneic hematopoietic stem cell transplantation (allo-SCT) is a curative treatment for myelodysplastic syndrome (MDS). The object of this study was to evaluate the impact of chemotherapy before allo-SCT. We analyzed the data of 283 patients who underwent allo-SCT from an HLA-identical sibling donor for MDS that were reported to the Japan Society for Hematopoietic Cell Transplantation. The cumulative incidence of grade II-IV acute GVHD was 33%. Overall survival (OS) at 5 and 10 years was 48.8 and 42.5%, respectively. Multivariate analyses identified karyotype, FAB classification, and the history of chemotherapy before allo-SCT as significant predictors for OS. OS at 5 years was 57% for patients who underwent allo-SCT as a primary treatment for refractory anemia with excess blasts in transformation (RAEB-t) or secondary acute myeloid leukemia (AML) and 54% for those who underwent allo-SCT in remission after induction chemotherapy (P = 0.81). The proportion of patients with a poor karyotype was equivalent between the two groups (P = 0.44). Although only a randomized controlled trial will be able to establish a definite conclusion, these results do not support the administration of induction chemotherapy for patients with RAEB-t or secondary AML before allo-SCT.

Original languageEnglish
Pages (from-to)396-401
Number of pages6
JournalLeukemia
Volume19
Issue number3
DOIs
Publication statusPublished - 2005 Mar

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Keywords

  • Allogeneic hematopoietic stem cell transplantation
  • Graft-versus-host disease
  • Myelodysplastic syndrome

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

Cite this

Nakai, K., Kanda, Y., Fukuhara, S., Sakamaki, H., Okamoto, S., Kodera, Y., Tanosaki, R., Takahashi, S., Matsushima, T., Atsuta, Y., Hamajima, N., Kasai, M., & Kato, S. (2005). Value of chemotherapy before allogeneic hematopoietic stem cell transplantation from an HLA-identical sibling donor for myelodysplastic syndrome. Leukemia, 19(3), 396-401. https://doi.org/10.1038/sj.leu.2403640