Stem cell transplantation for myelodysplastic syndromes: the lure of a cure.
Allogeneic stem cell transplantation is the only known curative therapy for myelodysplastic syndromes. However, the morbidity and mortality from this approach is high, especially in a population that tends to be elderly with comorbid conditions. In order to achieve a good outcome, the key is wise choice of the patient to undergo transplantation and appropriate timing of the therapy. Furthermore, consideration should be given to choosing whether the regimen should be fully myeloablative or reduced-intensity and whether marrow, peripheral-blood stem cells, or cord blood should be chosen for stem cell replacement. This article reviews the history of transplantation for this indication and the newer data driving decisions regarding the type of transplant and the optimal timing for best results.
Shore
Tsiporah
T
Bone Marrow and Hematopoietic Stem Cell Transplantation Program, Weill Medical College of Cornell University, 520 E 70th St., Suite ST 341, New York, NY 10021, USA. tbs2001@med.cornell.edu
D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation / Q000401:mortality / Q000639:trends; D002648:Child; D002675:Child, Preschool; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019653:Myeloablative Agonists / Q000008:administration & dosage / Q000009:adverse effects; D009190:Myelodysplastic Syndromes / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D011289:Preleukemia / Q000601:surgery; D011379:Prognosis; D012074:Remission Induction; D033581:Stem Cell Transplantation / Q000379:methods / Q000401:mortality / Q000639:trends; D019172:Transplantation Conditioning / Q000379:methods / Q000401:mortality; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous / Q000379:methods / Q000401:mortality; D016896:Treatment Outcome; D055815:Young Adult
D019653:Myeloablative Agonists