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In contrast to 5-azacytidine (5-aza), allogeneic stem cell transplantation (HSCT) represents a curative treatment strategy for patients with myelodysplastic syndrome (MDS), but treatment-related mortality (TRM) limits its use MDS is widely used in elderly patients
.
This is a prospective multi-center study comparing the prognosis of HSCT after 5-aza pretreatment with continuous 5-aza treatment in high-risk MDS patients aged 55-70 years
.
A total of 190 MDS patients (median age 63 years) were recruited
.
After receiving 4-6 courses of 5-aza, the test patients received HLA-compatible HSCT under reduced intensity conditions.
Twenty-eight patients were excluded from the analysis because they did not meet the inclusion criteria (n=20), died (n=2), withdrew from the study (n=5), and for unknown reasons (n=1)
.
162 patients underwent 5-aza induction therapy, but due to disease progression (n=26), death (n=12) or other reasons (n=16), only 108 (67%) patients were eligible for follow-up HSCT ( n=81) or continue 5-aza treatment
PFS and OS of patients with two treatment strategies
PFS and OS of patients with two treatment strategies7% of patients died during 5-aza treatment before grouping
.
The cumulative incidence of TRM one year after HSCT was 19%
The 3-year event-free survival rate and overall survival rate after 5-aza+HSCT were 34% (95% CI 22-47) and 50% (95% CI 39-61), respectively; and 3 years after continuous 5-aza treatment The annual event-free survival rate and overall survival rate were 0% (p<0.
In summary, in elderly patients with MDS, reduced-intensity conditional HSCT can significantly improve the event-free survival rate compared with continuous 5-aza therapy
.
Disease progression, death and adverse reactions are the main reasons why these patients cannot switch from 5-aza treatment to HSCT
In elderly patients with MDS, reduced-intensity conditioned HSCT can significantly improve the event-free survival rate compared to continuous 5-aza therapy.
Original source:
Nicolaus Kroger, et al.
omparison Between 5-Azacytidine Treatment and Allogeneic Stem-Cell Transplantation in Elderly Patients With Advanced MDS According to Donor Availability (VidazaAllo Study) in this message