Allogeneic HSCT an ‘Attractive’ Treatment Option for MDS Related to Therapy

Allogeneic hematopoietic stem cell transplant (HSCT) can yield favorable outcomes in treating patients with therapy-related myelodysplastic syndromes (MDS), according to a metaanalysis presented at the Eleventh Annual Meeting of the Society of Hematologic Oncology in Houston.

A multi-institutional research team led by Moazzam Shahzad, MD, of the H. Lee Moffitt Cancer Center and the University of South Florida in Tampa analyzed seven original studies that reported outcomes in patients treated with allogeneic HSCT for MDS related to therapy. They found positive results such as a pooled overall three-year survival rate of over 40% as well as an “acceptable” incidence of graft-versus-host disease (GVHD).

With current treatment options, patients with therapy-related MDS have a dismal prognosis. In their study, the researchers performed a systematic review and metaanalysis to assess allogeneic HSCT as a potential curative option. After screening 742 articles during their literature search, they ultimately included seven original studies that reported outcomes from allogeneic HSCT in adult patients with therapy-related MDS.

These studies included 1,275 patients with a median age of 56; 53% were male. The researchers recorded a median time of 67.5 months from prior treatment to development of therapy-related MDS and a median follow-up time of 32 months.

As for the type of donor, 36% were matched related, 27% were matched unrelated, 23% were an unrelated donor with unknown matching status, 12% were mismatched unrelated, and 3% were mismatched related. The stem cells source was peripheral (78%), bone marrow (13%), or cord blood (9%).

For the median follow-up of three years, the researchers found a 41.2% pooled OS rate and a 33.9% pooled progression-free survival rate. At a median follow-up of two years, the authors calculated a pooled relapse rate of 31.5% and nonrelapse mortality rate of 30.4%.

Meanwhile, there was a 30.9% pooled incidence of acute GVHD and 37.6% for chronic GVHD.

“[Allogeneic HSCT] is an attractive treatment modality for [therapy-related] MDS patients, with favorable outcomes and acceptable incidence of GVHD,” the authors concluded.

Reference

Shahzad M, Khalid MF, Butt A, et al. Outcomes with allogeneic hematopoietic stem cell transplant in therapy-related myelodysplastic neoplasms: A systematic review and meta-analysis. Abstract MDS-392. Presented at the Eleventh Annual Meeting of the Society of Hematologic Oncology; September 6-9, 2023; Houston, Texas.