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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 (requires institutional sign-in at Scopus site)   9 Citations

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




MESH terms used to index this publication - Major topics in bold

Hematopoietic Stem Cell Transplantation
Humans
Myelodysplastic Syndromes
Recurrence
Transplantation Conditioning