Stem cell transplant benefits older adults with MDS

Among older patients with myelodysplastic syndrome (MDS), survival rates are better for those undergoing allogeneic hematopoietic cell transplantation (HCT), according to a study presented at the annual meeting of the American Society of Hematology, held virtually from Dec. 5 to 8.

Ryotaro Nakamura, M.D., from the City of Hope in Duarte, California, and colleagues conducted a biologic assignment trial in older individuals (aged 50 to 75 years) with high-risk MDS who were candidates for reduced-intensity conditioning allogeneic HCT to examine the benefit of HCT versus non-HCT therapy. Based on human leukocyte antigen typing of eligible family members and a search of unrelated donor registries, participants were assigned to the donor or no donor arm. The primary analysis compared three-year overall survival (OS) between 384 subjects (260 in the donor arm and 124 in the no donor arm).

The researchers found that the adjusted OS at three years from study enrollment was 47.9 and 26.6 percent in the donor and no donor arms, respectively, in the intent-to-treat analysis. No effect was seen on outcome in sensitivity analysis excluding subjects assigned to the no donor arm who died or withdrew prior to the end of the 90-day search window (48.0 versus 28.1 percent). Compared with the no donor arm, the donor arm had greater leukemia-free survival at three years (35.8 versus 20.6 percent), with no difference seen in the sensitivity analysis.

“It is important to refer these patients early so that the transplant center can work on finding an optimal donor right from the get-go,” a coauthor said in a statement.

Several authors disclosed financial ties to the biopharmaceutical industry.