ASH 2020: Transplant Increases Overall Survival in Older, High-Risk Patients with Myelodysplastic Syndromes

Myelodysplastic Syndromes (MDS), also known as “bone marrow failure disorder,” are a group of diverse bone marrow disorders in which the bone marrow does not produce enough healthy blood cells. Patients who take chemotherapy drugs or who receive radiation therapy to treat Hodgkin and non-Hodgkin lymphoma are at risk of developing MDS for up to 10 years following treatment. Allogeneic hematopoietic cell transplantation (HCT) remains the only curative therapy for MDS. Although widely used in younger patients, HCT is infrequently offered to older patients because the relative benefits over non-HCT therapy have not been well defined.

In a multicenter, biologic assignment study, a trial compared older (aged 50-75) higher-risk de novo MDS patients (IPSS Intermediate-2 [Int-2] or High) who received reduced-intensity conditioning (RIC) allogeneic HCT with a suitable 8/8 human leukocyte antigen (HLA)-matched donor to those without a donor. Both patient cohorts underwent RIC HCT or non-HCT therapy according to institutional standards.

The adjusted overall survival rate at three years from study enrollment in the Donor cohort was 47.9 percent compared with 26.6 percent in the no-donor cohort. The researchers note a significant overall survival in older patients with high-risk MDS who are RIC HCT candidates and have an HLA-matched donor. The benefit of having a matched donor was seen across subgroups as well, including Medicare age (65+) and younger. It is recommended by the researchers that HCT should be offered to all individuals between the ages of 50 and 75 with Int-2 and High IPSS risk MDS where there is a suitable donor.

This study included contributions from LRF grantee, Mantle Cell Lymphoma Consortium member and past Scientific Advisory Board (SAB) member Stephen J. Forman, MD of City of Hope; and past SAB member Frederick R. Appelbaum, MD of Fred Hutchinson Cancer Research Center.

 

More Updates from the 2020 American Society of Hematology Annual Meeting

Widely regarded as the premier event in malignant and non-malignant hematology, the virtual ASH Annual Meeting held from December 5-8, 2020 provided a critical forum for leading hematologists /oncologists to present their findings to over 20,000 of their peers.
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