Abstract
| Original language | English |
|---|---|
| Pages (from-to) | 1753-1762 |
| Number of pages | 10 |
| Journal | Blood |
| Volume | 129 |
| Issue number | 13 |
| DOIs | |
| Publication status | Published - Mar 30 2017 |
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Keywords
- Hematopoietic Stem Cell Transplantation/methods
- Humans
- Leukemia, Myelomonocytic, Chronic/therapy
- Myelodysplastic Syndromes/therapy
- Practice Guidelines as Topic
- Risk Factors
- Transplantation Conditioning
- Transplantation, Homologous
Cite this
Allogeneic hematopoietic stem cell transplantation for MDS and CMML: recommendations from an international expert panel. / Witte, T. de; Bowen, D.; Robin, M.; Malcovati, L.; Niederwieser, D.; Yakoub-Agha, I.; Mufti, G. J.; Fenaux, P.; Sanz, G.; Martino, R.; Alessandrino, E. P.; Onida, F.; Symeonidis, A.; Passweg, J.; Kobbe, G.; Ganser, A.; Platzbecker, U.; Finke, J.; Gelder, M. van; Loosdrecht, A. A. van de; Ljungman, P.; Stauder, R.; Volin, L.; Deeg, H. J.; Cutler, C.; Saber, W.; Champlin, R.; Giralt, S.; Anasetti, C.; Kroger, N.
In: Blood, Vol. 129, No. 13, 30.03.2017, p. 1753-1762.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Allogeneic hematopoietic stem cell transplantation for MDS and CMML: recommendations from an international expert panel
AU - Witte, T. de
AU - Bowen, D.
AU - Robin, M.
AU - Malcovati, L.
AU - Niederwieser, D.
AU - Yakoub-Agha, I.
AU - Mufti, G. J.
AU - Fenaux, P.
AU - Sanz, G.
AU - Martino, R.
AU - Alessandrino, E. P.
AU - Onida, F.
AU - Symeonidis, A.
AU - Passweg, J.
AU - Kobbe, G.
AU - Ganser, A.
AU - Platzbecker, U.
AU - Finke, J.
AU - Gelder, M. van
AU - Loosdrecht, A. A. van de
AU - Ljungman, P.
AU - Stauder, R.
AU - Volin, L.
AU - Deeg, H. J.
AU - Cutler, C.
AU - Saber, W.
AU - Champlin, R.
AU - Giralt, S.
AU - Anasetti, C.
AU - Kroger, N.
N1 - LR: 20180112; CI: (c) 2017; GR: P30 CA008748/CA/NCI NIH HHS/United States; JID: 7603509; PMCR: 2018/03/30 00:00; 2016/06/25 00:00 [received]; 2017/01/04 00:00 [accepted]; 2018/03/30 00:00 [pmc-release]; 2017/01/18 06:00 [pubmed]; 2017/08/24 06:00 [medline]; 2017/01/19 06:00 [entrez]; ppublish
PY - 2017/3/30
Y1 - 2017/3/30
N2 - An international expert panel, active within the European Society for Blood and Marrow Transplantation, European LeukemiaNet, Blood and Marrow Transplant Clinical Trial Group, and the International Myelodysplastic Syndromes Foundation developed recommendations for allogeneic hematopoietic stem cell transplantation (HSCT) in myelodysplastic syndromes (MDS) and chronic myelomonocytic leukemia (CMML). Disease risks scored according to the revised International Prognostic Scoring System (IPSS-R) and presence of comorbidity graded according to the HCT Comorbidity Index (HCT-CI) were recognized as relevant clinical variables for HSCT eligibility. Fit patients with higher-risk IPSS-R and those with lower-risk IPSS-R with poor-risk genetic features, profound cytopenias, and high transfusion burden are candidates for HSCT. Patients with a very high MDS transplantation risk score, based on combination of advanced age, high HCT-CI, very poor-risk cytogenetic and molecular features, and high IPSS-R score have a low chance of cure with standard HSCT and consideration should be given to treating these patients in investigational studies. Cytoreductive therapy prior to HSCT is advised for patients with >/=10% bone marrow myeloblasts. Evidence from prospective randomized clinical trials does not provide support for specific recommendations on the optimal high intensity conditioning regimen. For patients with contraindications to high-intensity preparative regimens, reduced intensity conditioning should be considered. Optimal timing of HSCT requires careful evaluation of the available effective nontransplant strategies. Prophylactic donor lymphocyte infusion (DLI) strategies are recommended in patients at high risk of relapse after HSCT. Immune modulation by DLI strategies or second HSCT is advised if relapse occurs beyond 6 months after HSCT.
AB - An international expert panel, active within the European Society for Blood and Marrow Transplantation, European LeukemiaNet, Blood and Marrow Transplant Clinical Trial Group, and the International Myelodysplastic Syndromes Foundation developed recommendations for allogeneic hematopoietic stem cell transplantation (HSCT) in myelodysplastic syndromes (MDS) and chronic myelomonocytic leukemia (CMML). Disease risks scored according to the revised International Prognostic Scoring System (IPSS-R) and presence of comorbidity graded according to the HCT Comorbidity Index (HCT-CI) were recognized as relevant clinical variables for HSCT eligibility. Fit patients with higher-risk IPSS-R and those with lower-risk IPSS-R with poor-risk genetic features, profound cytopenias, and high transfusion burden are candidates for HSCT. Patients with a very high MDS transplantation risk score, based on combination of advanced age, high HCT-CI, very poor-risk cytogenetic and molecular features, and high IPSS-R score have a low chance of cure with standard HSCT and consideration should be given to treating these patients in investigational studies. Cytoreductive therapy prior to HSCT is advised for patients with >/=10% bone marrow myeloblasts. Evidence from prospective randomized clinical trials does not provide support for specific recommendations on the optimal high intensity conditioning regimen. For patients with contraindications to high-intensity preparative regimens, reduced intensity conditioning should be considered. Optimal timing of HSCT requires careful evaluation of the available effective nontransplant strategies. Prophylactic donor lymphocyte infusion (DLI) strategies are recommended in patients at high risk of relapse after HSCT. Immune modulation by DLI strategies or second HSCT is advised if relapse occurs beyond 6 months after HSCT.
KW - Hematopoietic Stem Cell Transplantation/methods
KW - Humans
KW - Leukemia, Myelomonocytic, Chronic/therapy
KW - Myelodysplastic Syndromes/therapy
KW - Practice Guidelines as Topic
KW - Risk Factors
KW - Transplantation Conditioning
KW - Transplantation, Homologous
U2 - 10.1182/blood-2016-06-724500 [doi]
DO - 10.1182/blood-2016-06-724500 [doi]
M3 - Article
VL - 129
SP - 1753
EP - 1762
JO - Blood
JF - Blood
SN - 0006-4971
IS - 13
ER -