title: Multicenter study evaluating the impact of hypomethylating agents as bridging therapy to hematopoietic stem cell transplantation in myelodysplastic syndromes.
abstract: Allogeneic hematopoietic stem cell transplantation (alloSCT) is currently the only curative treatment modality for myelodysplastic syndromes (MDS). The treatment paradigm for MDS has changed in recent years with the introduction of hypomethylating agents (HMAs). The present retrospective multicenter study was designed to assess the effects of pre-transplant HMA on transplant outcome and determine which patients would benefit most from this therapy. A total of 109 patients who received alloSCT at one of five institutions between 2007 and 2010 were enrolled in this study regardless of pre-transplant HMA therapy. 81 of the 109 patients enrolled were treated with HMA prior to alloSCT. 28 patients received alloSCT without HMA bridging. The distributions of WHO classification groups and IPSS scores were similar between the two groups (P = 0.752 and P = 0.265, respectively). Pre-transplant HMA did not affect OS (P = 0.244), and there were no differences in response to HMA therapy within the HMA-treated group. The cumulative incidence of NRM was not significantly different between the two groups (P = 0.500). However, for patients with a high blast count (>5 % of bone marrow at the time of diagnosis), pre-transplant HMA therapy had a NRM benefit (83.3 vs. 48.6 %, P = 0.014).
authors.affiliation: Severance Hospital, Yonsei University College of Medicine, 250 Seongsan-ro, Seodaemun-gu, Seoul, 120-752, Korea.
authors.forename: Yundeok
authors.initials: Y
authors.lastname: Kim
authors.forename: In-Ho
authors.initials: IH
authors.lastname: Kim
authors.forename: Hyeong Joon
authors.initials: HJ
authors.lastname: Kim
authors.forename: Silvia
authors.initials: S
authors.lastname: Park
authors.forename: Kyoo-Hyung
authors.initials: KH
authors.lastname: Lee
authors.forename: Soo Jeong
authors.initials: SJ
authors.lastname: Kim
authors.forename: Jung-Hee
authors.initials: JH
authors.lastname: Lee
authors.forename: Dae-Young
authors.initials: DY
authors.lastname: Kim
authors.forename: Sung-Soo
authors.initials: SS
authors.lastname: Yoon
authors.forename: Yeo-Keoung
authors.initials: YK
authors.lastname: Kim
authors.forename: Jun Ho
authors.initials: JH
authors.lastname: Jang
authors.forename: Seon Yang
authors.initials: SY
authors.lastname: Park
authors.forename: Jae-Sook
authors.initials: JS
authors.lastname: Ahn
authors.forename: Chul Won
authors.initials: CW
authors.lastname: Cheong
authors.forename: Je-Hwan
authors.initials: JH
authors.lastname: Lee
authors.forename: June-Won
authors.initials: JW
authors.lastname: Cheong
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D001374:Azacitidine / Q000627:therapeutic use*; D004248:DNA (Cytosine-5-)-Methyltransferases / Q000037:antagonists & inhibitors*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality / Q000628:therapy; D011300:Preoperative Care; D012189:Retrospective Studies; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000964:Antimetabolites, Antineoplastic; D004248:DNA (Cytosine-5-)-Methyltransferases; D001374:Azacitidine