Faculty Collaboration Database

Myeloablative versus Reduced-Intensity Hematopoietic Cell Transplantation in Myelodysplastic Syndromes: Systematic Review and Meta-analysis. Biol Blood Marrow Transplant 2020 Jun;26(6):e138-e141

Date

03/17/2020

Pubmed ID

32171885

DOI

10.1016/j.bbmt.2020.03.003

Scopus ID

2-s2.0-85083504564   1 Citation

Abstract

In a systematic review and meta-analysis, we compared allogeneic transplant outcomes after myeloablative conditioning (MAC) versus reduced-intensity conditioning (RIC) in patients with myelodysplastic syndromes. Only 2 published randomized clinical trials were found, with a pooled sample size of 183 (RIC, 92; MAC, 91). Both studies suggested an overall survival advantage after RIC, with a pooled hazard ratio (HR) of .67 (95% confidence interval [CI], .41 to 1.09) for RIC versus MAC. Relapse results were also concordant, with a pooled HR of 1.55 (95% CI, .74 to 3.25) for RIC versus MAC. Neither result was statistically significant. Comparisons for other outcomes were unremarkable. In conclusion, the evidence for the optimal conditioning intensity in myelodysplastic syndromes is weak. Post-transplant maintenance strategies and incorporation of genomic information into decision-making may improve post-transplant outcomes.

Author List

Rashidi A, Meybodi MA, Cao W, Chu H, Warlick ED, Devine S, Pasquini MC, Weisdorf DJ, Hamadani M

Authors

Mehdi H. Hamadani MD Professor in the Medicine department at Medical College of Wisconsin
Marcelo C. Pasquini MD, MS Professor in the Medicine department at Medical College of Wisconsin