التفاصيل البيبلوغرافية
العنوان:
Cytogenetics and comorbidity predict outcomes in older myelodysplastic syndrome patients after allogeneic stem cell transplantation using reduced intensity conditioning
المؤلفون:
Orhan Kemal, Yucel , Rima M, Saliba , Gabriella, Rondon , Sairah, Ahmed , Amin, Alousi , Qaiser, Bashir , Stefan O, Ciurea , Uday, Popat , Isa, Khouri , David, Marin , Katy, Rezvani , Partow, Kebriaei , Elizabeth J, Shpall , Richard E, Champlin , Betül, Oran
المصدر:
Cancer . 123(14)
سنة النشر:
2016
مصطلحات موضوعية:
Chromosome Aberrations , Male , Anemia, Refractory, with Excess of Blasts , Transplantation Conditioning , Hematopoietic Stem Cell Transplantation , Graft vs Host Disease , Leukemia, Myelomonocytic, Chronic , Comorbidity , Middle Aged , Prognosis , Survival Rate , Monosomy , Treatment Outcome , Risk Factors , Cause of Death , Myelodysplastic Syndromes , Disease Progression , Humans , Transplantation, Homologous , Female , Aged , Proportional Hazards Models , Retrospective Studies
الوصف:
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the only treatment with a curative potential for myelodysplastic syndrome (MDS) patients. Allo-HSCT has substantial risks, particularly in the elderly, and its role for older MDS patients has yet to be defined.We analyzed 88 MDS patients aged ≥ 60 years with allo-HSCT after reduced intensity conditioning regimens over the last decade. The study cohort had high risk features; 47 of 88 (53.4%) patients were 65 years of age, 24 (27%) patients had cytogenetic abnormalities consistent with monosomal karyotype (MKpos), 33 (38%) patients had histological subtype of RAEB-1 and RAEB-2 at diagnosis, and 45 (51%) patients had a hematopoietic cell transplantation-comorbidity index (HCT-CI) of ≥ 3.The 3-year incidence of progression, transplant-related mortality (TRM), and overall survival (OS) were 26% (95% confidence interval [CI], 18%-37%), 35% (95% CI, 26%-47%), and 41% (95% CI, 30%-52%), respectively. MKpos was the only prognostic factor that increased the risk of disease progression compared with good-risk cytogenetics (hazard ratio [HR] = 9.5, P = .003) as well as MKneg (HR = 3.3, P = .01). For TRM, HCT-CI ≥ 3, but not age65 years, was associated with worse outcomes (HR = 3.1, P = .007). Cytogenetics and HCT-CI enabled us to identify prognostic groups for OS. MKpos patients had the worst 3-year OS (17%), whereas patients with good-risk cytogenetics and HCT-CI 3 had the best OS (92%).Our results confirm that allo-HSCT can provide long-term survival in older MDS patients. Cytogenetics and HCT-CI identify prognostic risk groups and guide selection of older MDS patients who are candidates for allo-HSCT. Cancer 2017;123:2661-70. © 2017 American Cancer Society.
تدمد:
1097-0142
URL الوصول:
https://explore.openaire.eu/search/publication?articleId=pmid________::316c8813467fcf3ac461e68d8a887f76 https://pubmed.ncbi.nlm.nih.gov/28324640
رقم الانضمام:
edsair.pmid..........316c8813467fcf3ac461e68d8a887f76
قاعدة البيانات:
OpenAIRE