Allogeneic Stem Cell Transplantation for Myelodysplastic Syndrome Patients with a 5q Deletion

Laurent Garderet , Dimitris Ziagkos , Anja van Biezen , Simona Lacobelli , Juergen Finke , Johan Maertens , Liisa Volin , Per Ljungman , Patrice Chevallier , Jakob Passweg , Nicolaas Schaap , Dietrich Beelen , Arnon Nagler , Didier Blaise (1, 2) , Xavier Poire , Ibrahim Yakoub-Agha , Stig Lenhoff , Charles Craddock , Rik Schots , Alessandro Rambaldi , Jaime Sanz , Pavel Jindra , Ghulam J. Mufti , Marie Robin , Nicolaus Kroeger

1 Service d’Hématologie [Institut Paoli Calmettes, Marseille]
2 CRCM - Centre de Recherche en Cancérologie de Marseille

The deletion (5q) karyotype (del [5q]) in patients with myelodysplastic syndrome (MDS) is the most common karyotypic abnormality in de novo MDS. An increased number of blasts and additional karyotypic abnormalities (del [al]+) are associated with a poor outcome. We analyzed the outcome of allogeneic hematopoietic cell transplants (HCT) in patients suffering from MDS with only del (5q) or del (5q)+. A total of 162 patients, of median age 54 years (range, 9 to 73), having MDS and del (5q) abnormalities received HCT from identical siblings (n = 87) or unrelated donors (n = 75). The cumulative incidence of nonrelapse mortality and relapse incidence at 4 years was 29% (95% CI, 22 to 36) and 46% (95% CI, 38 to 54), whereas the estimated 4 year survival, relapse-free and overall, was 25% (95% CI, 18 to 33) and 30% (95% CI, 23 to 38), respectively. In a multivariate analysis patients with del (5q) and a blast excess displayed poorer survival (hazard ratio, 2.38; 95% CI, 1.44 to 3.93; P <.001), whereas female recipient sex resulted in improved survival (hazard ratio, .61; 95% CI, .41 to .90; P = .01). We conclude that allogeneic HCT can cure a subset of patients with MDS and a del (5q) abnormality. (C) 2017 American Society for Blood and Marrow Transplantation.

Domaines: Sciences du Vivant [q-bio]

Laurent Garderet, Dimitris Ziagkos, Anja van Biezen, Simona Lacobelli, Juergen Finke, et al.. Allogeneic Stem Cell Transplantation for Myelodysplastic Syndrome Patients with a 5q Deletion. BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION, 2018, 24 (3), pp.507-513. ⟨10.1016/j.bbmt.2017.11.017⟩. ⟨hal-02143674⟩