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The bridge treatment selected at the decision for transplantation did not affect the outcomes in patients with MDS
Author(s) -
Kako Shinichi,
Kanda Yoshinobu,
Kato Jun,
Yamamoto Wataru,
Kato Seiko,
Onizuka Makoto,
Yokota Akira,
Tatara Raine,
Yokoyama Hiroki,
Hagihara Maki,
Usuki Kensuke,
Gotoh Moritaka,
Watanabe Reiko,
Kawai Nobutaka,
Saitoh Takayuki,
Kanamori Heiwa,
Takahashi Satoshi,
Okamoto Shinichiro
Publication year - 2017
Publication title -
hematological oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 44
eISSN - 1099-1069
pISSN - 0278-0232
DOI - 10.1002/hon.2276
Subject(s) - medicine , transplantation , hematopoietic stem cell transplantation , surgery
The optimal treatment for use as a bridge to allogeneic hematopoietic stem cell transplantation at the decision for transplantation has not been established in patients with myelodysplastic syndrome (MDS). We retrospectively evaluated the clinical outcomes after the decision for transplantation in our patients with MDS or acute myeloid leukemia (AML) secondary to MDS, aged more than 15 years, who underwent transplantation between 2007 and 2012. A total of 124 patients were included. We classified patients into two groups according to the bridge treatment selected at the decision for transplantation: Group 1, supportive care ( n = 79), immunosuppressive therapy ( n = 7), low‐dose chemotherapy ( n = 12); Group 2, AML‐type induction chemotherapy (ICT: n = 22), azacitidine (Aza: n = 4). The rate of blasts in the bone marrow significantly influenced the treatment selection at the time of decision. There was no significant difference between the two groups in the rate of overall survival (OS) from the decision (73.1% vs 80.4% at 1 year) or from transplantation (59.0% vs 59.2% at 1 year). A significant difference was not observed even after patients were stratified according to either the rate of blasts in the bone marrow at the time of decision or the propensity score. In conclusion, the bridge treatment selected at the decision for transplantation did not affect the outcomes of transplantation in patients with MDS. However, this analysis did not include patients who could not undergo transplantation after the decision, and thus a prospective study is warranted. Copyright © 2015 John Wiley & Sons, Ltd.