title: Hematopoietic cell transplantation for adult patients with myelodysplastic syndromes and myeloproliferative disorders.
abstract: Hematopoietic cell transplantation (HCT) is currently the only treatment with curative potential for myelodysplastic syndromes (MDS) and myeloproliferative disorders (MPD). Among patients with less advanced MDS, 3-year survival rates of 65% to 75% are achieved with HLA-identical related and unrelated donors. The probability of relapse is less than 5%. Among patients with advanced MDS (> or = 5% marrow blasts), about 35% to 45% who receive transplants from related donors and 25% to 30% who receive transplants from unrelated donors are in remission beyond 3 years. The incidence of posttransplantation relapse is 10% to 35%. Criteria of the International Prognostic Scoring System (originally developed for nontransplant patients) also predict relapse and survival after HCT. Transplantation is successful in 50% to 80% of patients with MPD if performed before leukemic transformation. Depending on the individual risk profile, a considerable number of patients with MDS or MPD are cured by allogeneic HCT. However, HCT should be performed before disease progression. Outcome of patients with treatment-related MDS or with relapse after transplantation remains poor. At present, no definite conclusions can be made with regard to reduced-intensity transplantation regimens.
authors.affiliation: Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, D1-100, PO Box 19024, Seattle, WA 98109-1024, USA.
authors.forename: Martin
authors.initials: M
authors.lastname: Benesch
authors.forename: H Joachim
authors.initials: HJ
authors.lastname: Deeg
mesh_terms: D000328:Adult; D002908:Chronic Disease; D018450:Disease Progression; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D009190:Myelodysplastic Syndromes / Q000628:therapy*; D009196:Myeloproliferative Disorders / Q000628:therapy*; D012008:Recurrence; D012306:Risk; D016019:Survival Analysis