Outcome of allogeneic hematopoietic stem cell transplantation for hypoplastic myelodysplastic syndrome
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ORIGINAL ARTICLE
Outcome of allogeneic hematopoietic stem cell transplantation for hypoplastic myelodysplastic syndrome Ming Zhou1 · Liangliang Wu1 · Yuping Zhang1 · Wenjian Mo1 · Yumiao Li1 · Xiaowei Chen1 · Caixia Wang1 · Shiyi Pan1 · Shilin Xu1 · Wei Zhou1 · Tingfen Deng1 · Shunqing Wang1 Received: 6 July 2020 / Revised: 4 August 2020 / Accepted: 7 August 2020 © Japanese Society of Hematology 2020
Abstract The prognosis of patients with hypoplastic myelodysplastic syndrome (hMDS) after receiving allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains unclear. This study aimed to evaluate the outcomes of patients with hMDS after allo-HSCT. Between September 2013 and October 2019, a total of 20 consecutive patients with hMDS and 1 patient with clonal cytopenia of undermined significance (CCUS) who underwent allo-HSCT, which included procedures with 9 matched sibling donors, 2 matched unrelated donors, 4 mismatched unrelated donors and 6 haploidentical donors, were enrolled in this study. The median time for myeloid engraftment was 11 days (range 9–17 days), and that for platelet engraftment was 10 days (range 7–17 days). The cumulative incidence (CI) of myeloid and platelet recovery was 95.2 ± 6.0% and 90.5 ± 7.3%, respectively. The CI rates were 40.0 ± 11.3% for grades II–III acute graft-versus-host disease (GVHD), 36.8 ± 11.5% for chronic GVHD and 23.8 ± 9.6% for nonrelapse mortality. No patients experienced relapse. Sixteen surviving patients were followed up for a median of 1113 days (range 110–2305 days), and the overall survival and relapse-free survival rates were both 72.7 ± 10.6%. This limited retrospective analysis suggests that patients with hMDS had a favorable survival after allo-HSCT. Keywords Hypoplastic · Myelodysplastic syndrome · Allogeneic hematopoietic stem cell transplantation · Clonal cytopenia of undermined significance · Cytogenetic
Introduction Hypoplastic myelodysplastic syndrome (hMDS) is a group of distinct diseases characterized by reduced bone marrow (BM) cellularity and represents approximately 10–20% of all MDS cases [1, 2]. Although it is not recognized as a distinct entity by the French–American–British (FAB) and World Health Organization (WHO) classifications [3, 4], several studies have described how the specific clinical and biological characteristics of hMDS are different from those of their hypercellular/normocellular counterparts (non-hMDS) [1, 5–11]. Compared with non-hMDS patients, patients with Ming Zhou and Liangliang Wu contributed equally to this work. * Shunqing Wang [email protected] 1
Department of Hematology, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, 1 Panfu Road, Guangzhou 510180, Guangdong, People’s Republic of China
hMDS exhibit severe thrombocytopenia and neutropenia and lower blast counts, usually do not present karyotypic abnormalities, and have a lower probability of progressing to acute leukemia [1, 5, 11]. The percentage of refractory anemia (RA) and refractory cytopenias with
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