title: [Allogenic stem cell transplantation from genotypically HLA-identical siblings for 30 patients with myelodysplastic syndromes].
abstract: OBJECTIVE
  To explore the indication and optimum time for treating myelodysplastic syndrome (MDS) by allogeneic hematopoietic stem cell transplantation (allo-HSCT) with HLA identical sibling grafts.
  
  
  METHODS
  From June 1997 to Sep. 2004, a total of 30 patients with MDS were treated with allo-HSCT from HLA-identical sibling donors in our institute. On HSCT, 4 patients had refractory anemia (RA) , 2 RA with ringed sideroblasts (RARS) , 7 RA with excess blasts(RAEB) , 14 RAEB in transformation (RAEB-t) , 3 already progressed to secondary AML. For IPSS system, 6 patients were in intermediate- I risk group, 11 in intermediate- li risk group, and 13 in high risk group. The modified BU/CY conditioning regimen was used. Four patients received bone marrow transplantation (BMT), 8 received peripheral blood stem cell transplantation (PBSCT) , and 18 received BMT + PBSCT.
  
  
  RESULTS
  The 3-year expected overall survival (OS) was 63.61%, 3-year expected disease-free survival ( DFS) 61.41%, and relapse rate 5.26%; OS for RA/ RAS, RAEB and RAEB-t/AML subgroup was 83.33%, 34.29% and 66.67% , respectively, and all had no statistic difference among them. OS for IPSS-intermediate and high risk subgroup was 64.7% , and 69.0% respectively, also had no statistic difference. 3-year expected OS in no aGVHD,grade I - II aGVHD and grade III - IV aGVHD group was 57.75% , 100% and 0% , respectively (P = 0.009). Pre-HSCT chemotherapy, disease subtype and cGVHD all had no correlation with LFS or OS (P > 0.05).
  
  
  CONCLUSIONS
  For young MDS patients having HLA-identical sibling donors, HSCT should be the first line therapy and performed as soon as possible.
authors.affiliation: Institute of Hematology, Peking University People's Hospital, Beijing, China.
authors.forename: Lan-ping
authors.initials: LP
authors.lastname: Xu
authors.forename: Xiao-jun
authors.initials: XJ
authors.lastname: Huang
authors.forename: Kai-yan
authors.initials: KY
authors.lastname: Liu
authors.forename: Huan
authors.initials: H
authors.lastname: Chen
authors.forename: Dai-hong
authors.initials: DH
authors.lastname: Liu
authors.forename: Wei
authors.initials: W
authors.lastname: Han
authors.forename: Yu-hong
authors.initials: YH
authors.lastname: Chen
authors.forename: Zhi-yong
authors.initials: ZY
authors.lastname: Gao
authors.forename: Jin
authors.initials: J
authors.lastname: Lu
authors.forename: Jing-zhi
authors.initials: JZ
authors.lastname: Wang
authors.forename: Dao-pei
authors.initials: DP
authors.lastname: Lu
mesh_terms: D000293:Adolescent; D000328:Adult; D000075202:Contraindications; D005260:Female; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006650:Histocompatibility Testing; D006801:Humans; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000401:mortality / Q000601:surgery*; D011379:Prognosis; D015996:Survival Rate; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous