Hematopoietic Cell Transplantation in the Management of Myelodysplastic Syndrome: An Evidence-Based Review from the American Society for Transplantation and Cellular Therapy Committee on Practice Guidelines

Authors

Zachariah DeFilipp
Stefan O Ciurea
Corey Cutler
Marie Robin
Erica D Warlick
Ryotaro Nakamura
Andrew M Brunner
Bhagirathbhai Dholaria
Alison R Walker
Nicolaus Kröger
Nelli Bejanyan
Ehab Atallah
Roni Tamari
Melhem M Solh
Mary-Elizabeth Percival
Marcos de Lima
Bart Scott
Betul Oran
Guillermo Garcia-Manero
Mehdi Hamadani
Paul Carpenter
Amy E DeZern

Language

English

Publication Date

2-1-2023

Journal

Transplantation and Cellular Therapy

DOI

10.1016/j.jtct.2022.11.014

PMID

36436780

Abstract

The sole curative therapy for myelodysplastic syndrome (MDS) is allogeneic hematopoietic cell transplantation (HCT). Here this therapeutic modality is reviewed and critically evaluated in the context of the evidence. Specific criteria were used for searching the published literature and for grading the quality and strength of the evidence and the strength of the recommendations. A panel of MDS experts comprising transplantation and nontransplantation physicians developed consensus treatment recommendations. This review summarizes the standard MDS indications for HCT and addresses areas of controversy. Recent prospective trials have confirmed that allogeneic HCT confers survival benefits in patients with advanced or high-risk MDS compared with nontransplantation approaches, and the use of HCT is increasing in older patients with good performance status. However, patients with high-risk cytogenetic or molecular mutations remain at high risk for relapse. It is unknown whether administration of novel therapies before or after transplantation may decrease the risk of disease relapse in selected populations. Ongoing and future studies will investigate revised approaches to disease risk stratification, patient selection, and post-transplantation approaches to optimize allogeneic HCT outcomes for patients with MDS.

Keywords

Humans, United States, Aged, Transplantation Conditioning, Hematopoietic Stem Cell Transplantation, Myelodysplastic Syndromes, Transplantation, Homologous, Recurrence, Allogeneic hematopoietic cell transplantation, Evidence-based review, Guideline, Myelodysplastic syndrome

Published Open-Access

yes

Recommended Citation

DeFilipp, Zachariah; Ciurea, Stefan O; Cutler, Corey; et al., "Hematopoietic Cell Transplantation in the Management of Myelodysplastic Syndrome: An Evidence-Based Review from the American Society for Transplantation and Cellular Therapy Committee on Practice Guidelines" (2023). Faculty, Staff and Student Publications. 5720.
https://digitalcommons.library.tmc.edu/uthgsbs_docs/5720