[Place of hematopoietic stem cell transplantation in the treatment of myelodysplastic syndromes].
CONVENTIONAL TREATMENT: Myelodysplastic syndromes are hematopoietic stem cell disorders characterized by peripheral cytopenia, hypercellular bone marrow with dysplastic cell morphology and a tendency to evolve into acute myeloid leukemia. Supportive treatment with transfusions, antimicrobial agents, hematopoietic growth factors and conventional chemotherapy has only palliative character.
Allogeneic hematopoietic stem cell transplantation from HLA-matched family or unrelated donors is currently the only potentially curative therapy. Outcome is determined by disease-, patient- and treatment-related features, which will be discussed in this review.
Autologous transplantation is an alternative approach for patients which lack a suitable allogeneic stem cell donor. Autografts should be harvested in complete remission after intensive chemotherapy. Reduced treatment-related mortality is accompanied by increased risk of relapse.


CONCLUSIONS
Clinical trials are currently evaluating dose-modified preparative regimens with decreased toxicity, which offer transplantation options also to older patients or patients with comorbidities.
Kroschinsky
F
F
Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus, TU Dresden. kroschinsky@oncocenter.de
Bornhäuser
M
M
Ehninger
G
G
D002986:Clinical Trials as Topic; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D007951:Leukemia, Myeloid / Q000601:surgery; D009190:Myelodysplastic Syndromes / Q000209:etiology / Q000601:surgery*; D012074:Remission Induction; D016019:Survival Analysis; D019172:Transplantation Conditioning; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous