ABSTRACT

Objectives:

Myelodysplastic syndrome (MDS) is a clonal disease that progresses with cytopenias and has leukemia transformation. Allogeneic Stem Cell Transplantation (ASCT) is a curative treatment in MDS patients. However, to which patient group the ASCT transplant will be applied, the treatments to be given before, and the conditioning regimens applied during the transplant are among the controversial topics. In this study, it was aimed to evaluate MDS patients who were diagnosed and underwent ASCT in our unit.

Materials and Methods:

Forty-four MDS patients that were diagnosed at our center and underwent ASCT at Stem Cell Transplantation Unit between 1992 and 2016 were evaluated retrospectively.

Results:

Of the 44 patients included in the study, 31 were male (71%) and 13 were female (29%). The median age was 41 years, six patients (14%) were over 60 years old. Twenty-two of 31 patients with cytogenetic analysis were at high risk according to R-IPSS and nine patients were at intermediate risk. While complete response was observed in 32 patients (73%) after ASCT, engraftment was not achieved in 10 patients (22%). Two patients (5%) were not responsive to treatment. Mucositis developed in all patients and diarrhea developed in 39 patients (89%). The relationship of mucositis, diarrhea and engraftment kinetics with age (<60 years vs >60 years), R-IPSS, HCT-Cl score and the type of conditioning regimen was not shown. While 1-year overall survival was 73%, 1-year non-relapse mortality was 71%. In univariate regression analysis, high risk disease category, use of myeloablative conditioning regimen, acute graft versus host disease caused statistically significant decrease in overall survival. In the multivariate analysis, none of the factors affected the overall survival.

Conclusion:

Long term and sustainable response rates were achieved even if transplantation related toxicities were common in our cohort of MDS patients who underwent ASCT.

Keywords: Allogeneic Stem Cell Transplantation, Myelodysplastic Syndrome, Transplant Related Toxicity

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Allogeneic Stem Cell Transplantation in Myelodysplastic Syndrome

ABSTRACT

References