According to an investigation of outcomes and prognostic factors for second allogeneic hematopoietic stem cell transplantation (alloHSCT) in patients with myelodysplastic syndrome (MDS) who experienced relapse after first alloHSCT, early relapse and poor performance may correlate with inferior 5-year overall survival (OS). Results from the study were published in the British Journal of Haematology.

The Japanese Data Center for Haematopoietic Cell Transplantation contains data from 3419 patients with MDS who underwent first alloHSCT between January 1990 and December 2015. Of these patients, 630 developed disease recurrence, and 99 of these patients underwent potentially curative second alloHSCT. Data from these 99 patients were included in this study.

Median patient age was 53 years (interquartile range [IQR], 45-59), and 57.6% of patients were male. The 5-year OS was 25.3%. The authors suggested that this poor 5-year OS might be due to the high cumulative incidence of relapse in this cohort (43.5%) or nonrelapse mortality (34.5%).

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Early relapse was associated with inferior 5-year OS, with an adjusted hazard ratio (HR) of 2.78 (95% CI, 1.08-7.21; P =.035). Poor performance status was also associated with inferior 5-year OS, with an adjusted HR of 3.03 (95% CI, 1.71-5.37; P <.001).

One limitation of this study was that the authors could not access the genetic data of these patients, as certain genetic elements are strong prognostic markers in patients with MDS.

 “Although patients who received second alloHSCT had an unsatisfactory survival, we believe that appropriate candidate selection can improve survival rates,” the authors concluded.

Reference

  1. Shimomura Y, Hara M, Tachibana T, et al. Outcomes of second allogeneic haematopoietic stem cell transplantation in patients with relapse of myelodysplastic syndrome [published online April 2, 2019]. Br J Haematol. doi:10.1111/bjh.15898

This article originally appeared on Hematology Advisor