Allogeneic bone marrow transplantation for myelodysplastic syndrome: outcomes analysis according to IPSS score.
The objective of our analysis was to determine the post-transplantation outcomes for patients with myelodysplastic syndrome (MDS) according to their International Prognostic Scoring System (IPSS) risk categorization. Data for all MDS patients transplanted at our institution from 1981-1996 were reviewed. Multivariate analysis was used to determine factors predictive for non-relapse mortality, relapse, and disease-free survival. A total of 251 MDS patients (median age = 38 years) were transplanted from 1981-1996. The overall disease-free survival rate was 40%, with an 18% relapse rate. Older age, increasing disease duration, mismatched donors, male gender, and therapy-related MDS were factors that significantly enhanced the likelihood of non-relapse mortality. Increasing disease duration, morphology, and cytogenetics were significant in predicting relapses. Increasing age, disease morphology, and cytogenetics were significant in determining disease-free survival. IPSS score was found to correlate significantly with relapse and disease-free survival. The 5-year disease-free survival was 60%, 36%, and 28% for low and intermediate-1 risk, intermediate-2 risk, and high risk patients, respectively. We conclude that IPSS score may be used to predict relapse and disease-free survival in MDS patients undergoing allogeneic transplantation. Allogeneic transplantation may be recommended for patients with intermediate-1, intermediate-2, or high risk MDS.
Fred Hutchinson Cancer Research Center, Seattle, Washington 98109-1024, USA.
F R
FR
Appelbaum
J
J
Anderson
D000293:Adolescent; D000328:Adult; D000368:Aged; D016026:Bone Marrow Transplantation; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007223:Infant; D007621:Karyotyping; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009190:Myelodysplastic Syndromes / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome