ALLOGENEIC STEM CELL TRANSPLANTATION FOR MYELODYSPLASTIC SYNDROME
(Abstract release date: 05/21/15)
EHA Library. Sabrina A. 06/12/15; 102702; PB2032
Disclosure(s): Department of Hematology and Bone marrow transplant unit, Pierre and Marie Curie Center
Akhrouf Sabrina
Contributions
Contributions
Abstract
Abstract: PB2032
Type: Publication Only
Background
Myelodysplastic syndromes (MDS) are clonal hematopoietic disorders characterized by ineffective hematopoiesis, marrow dysplasia with cytopenias, abnormal blasts and variable rates of transformation to acute myeloid leukemia (AML). Allogeneic hematopoietic stem cell transplantation (HSCT) currently is the only potentially curative therapy for MDS. However, since most patients with MDS are older than 60 years, few are candidates for myeloablative transplantation. We present in this study our experience in HSCT for MDS.
Aims
Between May 2001 to June 2014 (13 years period), twenty two pts with MDS underwent allogeneic HSCT with HLA- identical sibling donors. The median age of the pts is 35,5 years (11-58), the Sex ratio is 1,44 (13M/9F), according to WHO classification 2008 (RA : 01, RA with del 5q : 01, RA with ring sideroblasts : 01, refractory cytopenia with multilineage dysplasia : 07, RA with excess blasts-1 : 07, RA with excess blasts-2 : 05), 20pts were transfusion-dependent before transplantation. Median time from diagnosis to allogeneic HSCT was 17, 2 months (7-52).
Methods
Myeloablative conditioning (MAC) was employed in 08pts and the reduced intensity conditioning (RIC) in 14pts. GVHD prophylaxis consisted of association of Cyclosporin and Methotrexate according to Seattle protocol. All pts received G-CSF mobilised peripheral blood stem cells, with a median CD34+ cell count : 5 ,8.106 /Kg (3,18-19,9). At 31 December 2014, a median time of follow-up is 41, 5 months (6-135).
Results
Neutropenia occured in all pts and the median duration of aplasia was 14 (7-23) days. Median time to achieve neutrophils count > 0,5.109/l : 13,5days (11-23) and platelets > 20.10ç/l : 13 days (9-35). Twenty pts (90%) required red blood cells transfusions (9, 9 units/pt) and 20 pts (90%) needed platelet transfusions (6 units/pt). Acute GVHD was observed in 05 cases (22,7%) grade II-IV and chronic GVHD in 07 pts (31,8%) of whom 5 with an extensive form.One pt (4,5%) relapsed at 4 months. 12 pts (54,5%) are still alive in complete remission, 10 pts (45,5%) died (4 : early severe infection, 1 : VOD, 1 : MAT, 3 : acute GVHD, 1 after relapse) . The overall survival (OS) and the Disease free survival (DFS) are respectively 52, 4% in all pts. The OS and DFS for RIC group are 53, 9%.
Summary
This study, after a long follow-up, suggests that allogeneic HSCT is the treatment of choice for pts with advanced stage MDS and pts with dependent transfusion. Relapse seems low (4,5%) in our study and no difference in term of OS between MAC and RIC group. The advantage of RIC is the possibility of HSCT for pts up to 60 years of age and older.
Keyword(s): Allogeneic bone marrow transplant, Myelodysplasia
Session topic: Publication Only
Type: Publication Only
Background
Myelodysplastic syndromes (MDS) are clonal hematopoietic disorders characterized by ineffective hematopoiesis, marrow dysplasia with cytopenias, abnormal blasts and variable rates of transformation to acute myeloid leukemia (AML). Allogeneic hematopoietic stem cell transplantation (HSCT) currently is the only potentially curative therapy for MDS. However, since most patients with MDS are older than 60 years, few are candidates for myeloablative transplantation. We present in this study our experience in HSCT for MDS.
Aims
Between May 2001 to June 2014 (13 years period), twenty two pts with MDS underwent allogeneic HSCT with HLA- identical sibling donors. The median age of the pts is 35,5 years (11-58), the Sex ratio is 1,44 (13M/9F), according to WHO classification 2008 (RA : 01, RA with del 5q : 01, RA with ring sideroblasts : 01, refractory cytopenia with multilineage dysplasia : 07, RA with excess blasts-1 : 07, RA with excess blasts-2 : 05), 20pts were transfusion-dependent before transplantation. Median time from diagnosis to allogeneic HSCT was 17, 2 months (7-52).
Methods
Myeloablative conditioning (MAC) was employed in 08pts and the reduced intensity conditioning (RIC) in 14pts. GVHD prophylaxis consisted of association of Cyclosporin and Methotrexate according to Seattle protocol. All pts received G-CSF mobilised peripheral blood stem cells, with a median CD34+ cell count : 5 ,8.106 /Kg (3,18-19,9). At 31 December 2014, a median time of follow-up is 41, 5 months (6-135).
Results
Neutropenia occured in all pts and the median duration of aplasia was 14 (7-23) days. Median time to achieve neutrophils count > 0,5.109/l : 13,5days (11-23) and platelets > 20.10ç/l : 13 days (9-35). Twenty pts (90%) required red blood cells transfusions (9, 9 units/pt) and 20 pts (90%) needed platelet transfusions (6 units/pt). Acute GVHD was observed in 05 cases (22,7%) grade II-IV and chronic GVHD in 07 pts (31,8%) of whom 5 with an extensive form.One pt (4,5%) relapsed at 4 months. 12 pts (54,5%) are still alive in complete remission, 10 pts (45,5%) died (4 : early severe infection, 1 : VOD, 1 : MAT, 3 : acute GVHD, 1 after relapse) . The overall survival (OS) and the Disease free survival (DFS) are respectively 52, 4% in all pts. The OS and DFS for RIC group are 53, 9%.
Summary
This study, after a long follow-up, suggests that allogeneic HSCT is the treatment of choice for pts with advanced stage MDS and pts with dependent transfusion. Relapse seems low (4,5%) in our study and no difference in term of OS between MAC and RIC group. The advantage of RIC is the possibility of HSCT for pts up to 60 years of age and older.
Keyword(s): Allogeneic bone marrow transplant, Myelodysplasia
Session topic: Publication Only
Abstract: PB2032
Type: Publication Only
Background
Myelodysplastic syndromes (MDS) are clonal hematopoietic disorders characterized by ineffective hematopoiesis, marrow dysplasia with cytopenias, abnormal blasts and variable rates of transformation to acute myeloid leukemia (AML). Allogeneic hematopoietic stem cell transplantation (HSCT) currently is the only potentially curative therapy for MDS. However, since most patients with MDS are older than 60 years, few are candidates for myeloablative transplantation. We present in this study our experience in HSCT for MDS.
Aims
Between May 2001 to June 2014 (13 years period), twenty two pts with MDS underwent allogeneic HSCT with HLA- identical sibling donors. The median age of the pts is 35,5 years (11-58), the Sex ratio is 1,44 (13M/9F), according to WHO classification 2008 (RA : 01, RA with del 5q : 01, RA with ring sideroblasts : 01, refractory cytopenia with multilineage dysplasia : 07, RA with excess blasts-1 : 07, RA with excess blasts-2 : 05), 20pts were transfusion-dependent before transplantation. Median time from diagnosis to allogeneic HSCT was 17, 2 months (7-52).
Methods
Myeloablative conditioning (MAC) was employed in 08pts and the reduced intensity conditioning (RIC) in 14pts. GVHD prophylaxis consisted of association of Cyclosporin and Methotrexate according to Seattle protocol. All pts received G-CSF mobilised peripheral blood stem cells, with a median CD34+ cell count : 5 ,8.106 /Kg (3,18-19,9). At 31 December 2014, a median time of follow-up is 41, 5 months (6-135).
Results
Neutropenia occured in all pts and the median duration of aplasia was 14 (7-23) days. Median time to achieve neutrophils count > 0,5.109/l : 13,5days (11-23) and platelets > 20.10ç/l : 13 days (9-35). Twenty pts (90%) required red blood cells transfusions (9, 9 units/pt) and 20 pts (90%) needed platelet transfusions (6 units/pt). Acute GVHD was observed in 05 cases (22,7%) grade II-IV and chronic GVHD in 07 pts (31,8%) of whom 5 with an extensive form.One pt (4,5%) relapsed at 4 months. 12 pts (54,5%) are still alive in complete remission, 10 pts (45,5%) died (4 : early severe infection, 1 : VOD, 1 : MAT, 3 : acute GVHD, 1 after relapse) . The overall survival (OS) and the Disease free survival (DFS) are respectively 52, 4% in all pts. The OS and DFS for RIC group are 53, 9%.
Summary
This study, after a long follow-up, suggests that allogeneic HSCT is the treatment of choice for pts with advanced stage MDS and pts with dependent transfusion. Relapse seems low (4,5%) in our study and no difference in term of OS between MAC and RIC group. The advantage of RIC is the possibility of HSCT for pts up to 60 years of age and older.
Keyword(s): Allogeneic bone marrow transplant, Myelodysplasia
Session topic: Publication Only
Type: Publication Only
Background
Myelodysplastic syndromes (MDS) are clonal hematopoietic disorders characterized by ineffective hematopoiesis, marrow dysplasia with cytopenias, abnormal blasts and variable rates of transformation to acute myeloid leukemia (AML). Allogeneic hematopoietic stem cell transplantation (HSCT) currently is the only potentially curative therapy for MDS. However, since most patients with MDS are older than 60 years, few are candidates for myeloablative transplantation. We present in this study our experience in HSCT for MDS.
Aims
Between May 2001 to June 2014 (13 years period), twenty two pts with MDS underwent allogeneic HSCT with HLA- identical sibling donors. The median age of the pts is 35,5 years (11-58), the Sex ratio is 1,44 (13M/9F), according to WHO classification 2008 (RA : 01, RA with del 5q : 01, RA with ring sideroblasts : 01, refractory cytopenia with multilineage dysplasia : 07, RA with excess blasts-1 : 07, RA with excess blasts-2 : 05), 20pts were transfusion-dependent before transplantation. Median time from diagnosis to allogeneic HSCT was 17, 2 months (7-52).
Methods
Myeloablative conditioning (MAC) was employed in 08pts and the reduced intensity conditioning (RIC) in 14pts. GVHD prophylaxis consisted of association of Cyclosporin and Methotrexate according to Seattle protocol. All pts received G-CSF mobilised peripheral blood stem cells, with a median CD34+ cell count : 5 ,8.106 /Kg (3,18-19,9). At 31 December 2014, a median time of follow-up is 41, 5 months (6-135).
Results
Neutropenia occured in all pts and the median duration of aplasia was 14 (7-23) days. Median time to achieve neutrophils count > 0,5.109/l : 13,5days (11-23) and platelets > 20.10ç/l : 13 days (9-35). Twenty pts (90%) required red blood cells transfusions (9, 9 units/pt) and 20 pts (90%) needed platelet transfusions (6 units/pt). Acute GVHD was observed in 05 cases (22,7%) grade II-IV and chronic GVHD in 07 pts (31,8%) of whom 5 with an extensive form.One pt (4,5%) relapsed at 4 months. 12 pts (54,5%) are still alive in complete remission, 10 pts (45,5%) died (4 : early severe infection, 1 : VOD, 1 : MAT, 3 : acute GVHD, 1 after relapse) . The overall survival (OS) and the Disease free survival (DFS) are respectively 52, 4% in all pts. The OS and DFS for RIC group are 53, 9%.
Summary
This study, after a long follow-up, suggests that allogeneic HSCT is the treatment of choice for pts with advanced stage MDS and pts with dependent transfusion. Relapse seems low (4,5%) in our study and no difference in term of OS between MAC and RIC group. The advantage of RIC is the possibility of HSCT for pts up to 60 years of age and older.
Keyword(s): Allogeneic bone marrow transplant, Myelodysplasia
Session topic: Publication Only
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