Frontiers in Immunology (Feb 2023)
Appropriate pre-transplant strategy for patients with myelodysplastic syndromes receiving allogeneic haematopoietic stem cell transplantation after myeloablative conditioning
- Hong Wang,
- Hong Wang,
- Hong Wang,
- Hong Wang,
- Qingyuan Wang,
- Qingyuan Wang,
- Qingyuan Wang,
- Qingyuan Wang,
- Jiaqian Qi,
- Jiaqian Qi,
- Jiaqian Qi,
- Jiaqian Qi,
- Xueqian Li,
- Xueqian Li,
- Xueqian Li,
- Tiantian Chu,
- Tiantian Chu,
- Tiantian Chu,
- Tiantian Chu,
- Huiying Qiu,
- Huiying Qiu,
- Huiying Qiu,
- Huiying Qiu,
- Chengcheng Fu,
- Chengcheng Fu,
- Chengcheng Fu,
- Chengcheng Fu,
- Xiaowen Tang,
- Xiaowen Tang,
- Xiaowen Tang,
- Xiaowen Tang,
- Changgeng Ruan,
- Changgeng Ruan,
- Changgeng Ruan,
- Changgeng Ruan,
- Depei Wu,
- Depei Wu,
- Depei Wu,
- Depei Wu,
- Yue Han,
- Yue Han,
- Yue Han,
- Yue Han
Affiliations
- Hong Wang
- National Clinical Research Centre for Haematologic Diseases, Jiangsu Institute of Haematology, The First Affiliated Hospital of Soochow University, Suzhou, China
- Hong Wang
- Institute of Blood and Marrow Transplantation, Collaborative Innovation Centre of Haematology, Soochow University, Suzhou, China
- Hong Wang
- Key Laboratory of Thrombosis and Haemostasis of Ministry of Health, Suzhou, China
- Hong Wang
- State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou, China
- Qingyuan Wang
- National Clinical Research Centre for Haematologic Diseases, Jiangsu Institute of Haematology, The First Affiliated Hospital of Soochow University, Suzhou, China
- Qingyuan Wang
- Institute of Blood and Marrow Transplantation, Collaborative Innovation Centre of Haematology, Soochow University, Suzhou, China
- Qingyuan Wang
- Key Laboratory of Thrombosis and Haemostasis of Ministry of Health, Suzhou, China
- Qingyuan Wang
- State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou, China
- Jiaqian Qi
- National Clinical Research Centre for Haematologic Diseases, Jiangsu Institute of Haematology, The First Affiliated Hospital of Soochow University, Suzhou, China
- Jiaqian Qi
- Institute of Blood and Marrow Transplantation, Collaborative Innovation Centre of Haematology, Soochow University, Suzhou, China
- Jiaqian Qi
- Key Laboratory of Thrombosis and Haemostasis of Ministry of Health, Suzhou, China
- Jiaqian Qi
- State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou, China
- Xueqian Li
- National Clinical Research Centre for Haematologic Diseases, Jiangsu Institute of Haematology, The First Affiliated Hospital of Soochow University, Suzhou, China
- Xueqian Li
- Institute of Blood and Marrow Transplantation, Collaborative Innovation Centre of Haematology, Soochow University, Suzhou, China
- Xueqian Li
- Key Laboratory of Thrombosis and Haemostasis of Ministry of Health, Suzhou, China
- Tiantian Chu
- National Clinical Research Centre for Haematologic Diseases, Jiangsu Institute of Haematology, The First Affiliated Hospital of Soochow University, Suzhou, China
- Tiantian Chu
- Institute of Blood and Marrow Transplantation, Collaborative Innovation Centre of Haematology, Soochow University, Suzhou, China
- Tiantian Chu
- Key Laboratory of Thrombosis and Haemostasis of Ministry of Health, Suzhou, China
- Tiantian Chu
- State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou, China
- Huiying Qiu
- National Clinical Research Centre for Haematologic Diseases, Jiangsu Institute of Haematology, The First Affiliated Hospital of Soochow University, Suzhou, China
- Huiying Qiu
- Institute of Blood and Marrow Transplantation, Collaborative Innovation Centre of Haematology, Soochow University, Suzhou, China
- Huiying Qiu
- Key Laboratory of Thrombosis and Haemostasis of Ministry of Health, Suzhou, China
- Huiying Qiu
- State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou, China
- Chengcheng Fu
- National Clinical Research Centre for Haematologic Diseases, Jiangsu Institute of Haematology, The First Affiliated Hospital of Soochow University, Suzhou, China
- Chengcheng Fu
- Institute of Blood and Marrow Transplantation, Collaborative Innovation Centre of Haematology, Soochow University, Suzhou, China
- Chengcheng Fu
- Key Laboratory of Thrombosis and Haemostasis of Ministry of Health, Suzhou, China
- Chengcheng Fu
- State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou, China
- Xiaowen Tang
- National Clinical Research Centre for Haematologic Diseases, Jiangsu Institute of Haematology, The First Affiliated Hospital of Soochow University, Suzhou, China
- Xiaowen Tang
- Institute of Blood and Marrow Transplantation, Collaborative Innovation Centre of Haematology, Soochow University, Suzhou, China
- Xiaowen Tang
- Key Laboratory of Thrombosis and Haemostasis of Ministry of Health, Suzhou, China
- Xiaowen Tang
- State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou, China
- Changgeng Ruan
- National Clinical Research Centre for Haematologic Diseases, Jiangsu Institute of Haematology, The First Affiliated Hospital of Soochow University, Suzhou, China
- Changgeng Ruan
- Institute of Blood and Marrow Transplantation, Collaborative Innovation Centre of Haematology, Soochow University, Suzhou, China
- Changgeng Ruan
- Key Laboratory of Thrombosis and Haemostasis of Ministry of Health, Suzhou, China
- Changgeng Ruan
- State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou, China
- Depei Wu
- National Clinical Research Centre for Haematologic Diseases, Jiangsu Institute of Haematology, The First Affiliated Hospital of Soochow University, Suzhou, China
- Depei Wu
- Institute of Blood and Marrow Transplantation, Collaborative Innovation Centre of Haematology, Soochow University, Suzhou, China
- Depei Wu
- Key Laboratory of Thrombosis and Haemostasis of Ministry of Health, Suzhou, China
- Depei Wu
- State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou, China
- Yue Han
- National Clinical Research Centre for Haematologic Diseases, Jiangsu Institute of Haematology, The First Affiliated Hospital of Soochow University, Suzhou, China
- Yue Han
- Institute of Blood and Marrow Transplantation, Collaborative Innovation Centre of Haematology, Soochow University, Suzhou, China
- Yue Han
- Key Laboratory of Thrombosis and Haemostasis of Ministry of Health, Suzhou, China
- Yue Han
- State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou, China
- DOI
- https://doi.org/10.3389/fimmu.2023.1146619
- Journal volume & issue
-
Vol. 14
Abstract
PurposeAppropriate pre-transplant strategies in patients with myelodysplastic syndromes (MDS) remain challenging. We sought to assess the effect of different pre-transplant therapies and transplantation interval times on patient prognosis.MethodsWe retrospectively analysed clinical data for 371 consecutive MDS patients after myeloablative transplantation between 2007 and 2019.ResultsThe median age of the patients was 38 years (range, 12–64 years). A total of 114 patients (31%) received supportive care (SC), 108 (29%) hypomethylating agents (HMAs), and 149 (40%) chemotherapy-based therapy before transplantation. In patients who received HMA or SC, there was no significant difference in overall survival (OS; P=0.151) or relapse-free survival (RFS; P=0.330), except that HMA-treated patients had a lower rate of non-relapse mortality (5-year NRM: 18% vs. 32%, P=0.035). However, compared with patients who received HMA, those who received chemotherapy-based therapy had a lower 5-year OS rate (56% vs. 69%, P=0.020) and a slightly higher 5-year NRM rate (28% vs. 18%, P=0.067). Compared to the delayed transplant group (transplant interval ≥6 months), the early transplant group (transplant interval <6 months) had a superior 5-year OS (66% vs. 51%, P=0.001) and a lower 5-year cumulative incidence of NRM (22% vs. 36%, P=0.001).ConclusionThe findings of the study indicate that receiving an appropriate pre-transplant strategy (SC/HMA + <6 months) significantly improves OS and decreases NRM in MDS patients after myeloablative transplantation.
Keywords
- myelodysplastic syndrome
- pre-transplant strategy
- myeloablative conditioning
- haematopoietic stem cell transplantation
- prognosis
