Prognostic pre-transplant factors in myelodysplastic syndromes primarily treated by high dose allogeneic hematopoietic stem cell transplantation : a retrospective study of the MDS subcommittee of the CMWP of the EBMT

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Cremers , E M P , van Biezen , A , de Wreede , L C , Scholten , M , Vitek , A , Finke , J , Platzbecker , U , Beelen , D , Schwerdtfeger , R , Volin , L , Harhalakis , N , Blijlevens , N , Nagler , A , Kroger , N & de Witte , T 2016 , ' Prognostic pre-transplant factors in myelodysplastic syndromes primarily treated by high dose allogeneic hematopoietic stem cell transplantation : a retrospective study of the MDS subcommittee of the CMWP of the EBMT ' Annals of Hematology , vol. 95 , no. 12 , pp. 1971-1978 . DOI: 10.1007/s00277-016-2802-z

Title: Prognostic pre-transplant factors in myelodysplastic syndromes primarily treated by high dose allogeneic hematopoietic stem cell transplantation : a retrospective study of the MDS subcommittee of the CMWP of the EBMT
Author: Cremers, E. M. P.; van Biezen, A.; de Wreede, L. C.; Scholten, M.; Vitek, A.; Finke, J.; Platzbecker, U.; Beelen, D.; Schwerdtfeger, R.; Volin, L.; Harhalakis, N.; Blijlevens, N.; Nagler, A.; Kroger, N.; de Witte, T.
Contributor: University of Helsinki, Department of Medicine
Date: 2016-12
Language: eng
Number of pages: 8
Belongs to series: Annals of Hematology
ISSN: 0939-5555
URI: http://hdl.handle.net/10138/170093
Abstract: Many pre-transplant factors are known to influence the outcome of allogeneic stem cell transplantation (SCT) treatment in myelodysplastic syndromes (MDS). However, patient cohorts are often heterogeneous by disease stage and treatment modalities, which complicates interpretation of the results. This study aimed to obtain a homogeneous patient cohort by including only de novo MDS patients who received upfront allogeneic SCT after standard high dose myelo-ablative conditioning. The effect of pre-transplant factors such as age, disease stage, transfusions, iron parameters and comorbidity on overall survival (OS), non-relapse mortality (NRM), and relapse incidence (RI) was evaluated in 201 patients. In this cohort, characterized by low comorbidity and a short interval between diagnosis and transplantation, NRM was the most determinant factor for survival after SCT (47 % after 2-year follow-up). WHO classification and transfusion burden were the only modalities with a significant impact on overall survival after SCT. Estimated hazard ratios (HR) showed a strongly increased risk of death, NRM and RI, in patients with a high transfusion-burden (HR 1.99; P = 0.006, HR of 1.89; P = 0.03 and HR 2.67; P = 0.03). The HR's for ferritin level and comorbidity were not significantly increased.
Subject: Myelodysplastic syndromes
Red blood cell transfusion
Iron overload
Allogeneic hematopoietic stem cell transplantation
Comorbidity
Allogeneic stem cell transplantation
Prognosis
BONE-MARROW-TRANSPLANTATION
IRON OVERLOAD
BOUND IRON
ALLO-SCT
TRANSFUSION
IMPACT
CHEMOTHERAPY
CHELATION
REGIMENS
INDEX
3121 Internal medicine
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