Myeloablative versus Reduced-Intensity Hematopoietic Cell Transplantation in Myelodysplastic Syndromes: Systematic Review and Meta-analysis.

Hematopoietic Stem Cell Transplantation Humans Myelodysplastic Syndromes / therapy Recurrence Transplantation Conditioning
Meta-analysis Myeloablative Myelodysplastic syndromes Reduced intensity Transplantation

Journal

Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation
ISSN: 1523-6536
Titre abrégé: Biol Blood Marrow Transplant
Pays: United States
ID NLM: 9600628

Informations de publication

Date de publication:
06 2020
Historique:
received: 07 02 2020
revised: 29 02 2020
accepted: 02 03 2020
pubmed: 17 3 2020
medline: 24 6 2021
entrez: 16 3 2020
Statut: ppublish

Résumé

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.

Identifiants

DOI: 10.1016/j.bbmt.2020.03.003 PMID: 32171885
pubmed: 32171885
pii: S1083-8791(20)30138-5
doi: 10.1016/j.bbmt.2020.03.003
pii:
doi:

Types de publication

Journal Article Meta-Analysis Research Support, Non-U.S. Gov't Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

e138-e141

Informations de copyright

Copyright © 2020 American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc. All rights reserved.

Auteurs

Armin Rashidi (A)

Division of Hematology, Oncology, and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, Minnesota. Electronic address: arashidi@umn.edu.

Mohamad A Meybodi (MA)

Division of Hematology, Oncology, and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, Minnesota.

Wenhao Cao (W)

Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota.

Haitao Chu (H)

Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota.

Erica D Warlick (ED)

Division of Hematology, Oncology, and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, Minnesota.

Steven Devine (S)

Center for International Blood and Marrow Transplantation Research, Minneapolis, Minnesota.

Marcelo C Pasquini (MC)

BMT & Cellular Therapy Program, Division of Hematology & Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin.

Daniel J Weisdorf (DJ)

Division of Hematology, Oncology, and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, Minnesota.

Mehdi Hamadani (M)

BMT & Cellular Therapy Program, Division of Hematology & Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin.

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Classifications MeSH

questionsmedicales.fr › Procédures de chirurgie opératoire › Transplantation › Transplantation cellulaire › Transplantation de cellules souches › Transplantation de cellules souches hématopoïétiques › Myeloablative versus Reduced-Intensity...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Myeloablative versus Reduced-Intensity...
questionsmedicales.fr › Hémopathies et maladies lymphatiques › Hémopathies › Maladies de la moelle osseuse › Syndromes myélodysplasiques › Myeloablative versus Reduced-Intensity...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Caractéristiques de la maladie › Récidive › Myeloablative versus Reduced-Intensity...
questionsmedicales.fr › Techniques d'investigation › Techniques immunologiques › Immunosuppression thérapeutique › Conditionnement pour greffe › Myeloablative versus Reduced-Intensity...