Long-term follow-up of a retrospective comparison of reduced-intensity conditioning and conventional high-dose conditioning for allogeneic transplantation from matched related donors in myelodysplastic syndromes.
This study shows the long-term updated outcomes of a multicenter retrospective study which analyzed 843 patients with myelodysplastic syndrome (MDS) who underwent transplantation with an HLA-identical sibling donor with either reduced-intensity conditioning (RIC) in 213 patients, or standard myeloablative conditioning (MAC) in 630 patients. In multivariate analysis, the 13-year relapse rate was significantly increased after RIC (31% after MAC vs 48% in RIC; HR, 1.5; 95% CI, 1.1-1.9; P=0.04), but with no differences in overall survival (OS) (30% after MAC vs 27% in RIC; P=0.4) and PFS (29 vs 21%, respectively, P=0.3). Non-relapse mortality was higher in MAC (40 vs 31%; P=0.1), especially in patients older than 50 years (50 vs 33%, P<0.01). In addition, long-term follow-up confirms the importance of other variables on 13-year OS, mainly MDS risk category, disease phase, cytogenetics and receiving a high donor cell dose, irrespective of the conditioning regimen used.
Hospital Santa Creu i Sant Pau, Barcelona, Spain.
R
R
Martino
EBMT Data Office, Leiden, The Netherlands.
A
A
Henseler
Ospedale San Martino, Genova, Italy.
M
M
van Lint
Radboud University-Nijmegen Medical Center, Nijmegen, The Netherlands.
N
N
Schaap
University of Freiburg, Freiburg, Germany.
J
J
Finke
University Hospital, Essen, Germany.
D
D
Beelen
Hôpital Haut-Leveque, Pessac, France.
S
S
Vigouroux
Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
E P
EP
Alessandrino
GKT School of Medicine, London, UK.
G J
GJ
Mufti
Leiden University Hospital, Leiden, The Netherlands.
J H
JH
Veelken
A.O.U Citta della Salute e della Scienza di Torino, Torino, Italy.
B
B
Bruno
CHU de Lille, CIRIC INSERM U995, Université de Lille 2, Lille, France.
I
I
Yakoub-Agha
HUCH Comprehensive Cancer Center, Helsinki, Finland.
L
L
Volin
University Hospital Gasthuisberg, Leuven, Belgium.
J
J
Maertens
Hadassah University Hospital, Jerusalem, Israel.
R
R
Or
Universite Paris IV, Hopital la Pitié-Salpêtrière, Paris, France.
V
V
Leblond
Hospital Clinic, Barcelona, Spain.
M
M
Rovira
Medizinische Universitaet Wien, Vienna, Austria.
P
P
Kalhs
Hospital de la Princesa, Madrid, Spain.
A F
AF
Alvarez
Institute of Hematology and Blood Transfusion, Prague, Czech Republic.
A
A
Vitek
Hospital Santa Creu i Sant Pau, Barcelona, Spain.
J
J
Sierra
University Medical Center Mainz, Mainz, Germany.
E
E
Wagner
Hopital St. Louis, Paris, France.
M
M
Robin
Radboud University-Nijmegen Medical Center, Nijmegen, The Netherlands.
T
T
de Witte
University Hospital Eppendorf, Hamburg, Germany.
N
N
Kröger
D000368:Aged; D016022:Case-Control Studies; D005500:Follow-Up Studies; D006650:Histocompatibility Testing; D006801:Humans; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000401:mortality / Q000628:therapy*; D012189:Retrospective Studies; D035781:Siblings; D016019:Survival Analysis; D014019:Tissue Donors; D019172:Transplantation Conditioning / Q000379:methods* / Q000401:mortality