PMID- 10365533
OWN - NLM
STAT- MEDLINE
DCOM- 19990708
LR  - 20161013
IS  - 0929-6646 (Print)
IS  - 0929-6646 (Linking)
VI  - 98
IP  - 3
DP  - 1999 Mar
TI  - Allogeneic stem cell transplantation for patients with high-risk myelodysplastic 
      syndrome.
PG  - 157-64
AB  - Allogeneic stem cell transplantation (allo-SCT) is the only treatment with 
      curative potential for patients with myelodysplastic syndrome (MDS). From June 
      1986 to April 1997, we treated 12 patients with primary MDS (5 men, 7 women, 
      median age, 36.5 years) by allo-SCT. All patients had one or more of the 
      following poor prognostic factors: intermediate-2 or high-risk categories 
      according to the International Prognostic Scoring System; disease progression 
      during follow-up; heavy transfusion requirements and recurrent infections. The 
      median duration from diagnosis of MDS to allo-SCT was 6 months. The 
      preconditioning regimen included total body irradiation combined with either 
      high-dose cytarabine (n = 6), high-dose cyclophosphamide (n = 4), or other 
      regimens (n = 2). Ten patients received bone marrow transplantations and two 
      patients received peripheral blood stem cell transplantations. Prophylaxis for 
      graft-versus-host disease (GVHD) consisted of standard cyclosporin and 
      short-course methotrexate. Acute GVHD of grade 2 or above occurred in 10 
      patients, while chronic GVHD occurred in seven of the nine patients who survived 
      longer than 6 months after allo-SCT. With a median follow-up of 50 months, all 
      nine patients with human leukocyte antigen (HLA)-matched sibling donors survived. 
      One patient had a relapse 6 months after transplantation and achieved complete 
      remission again with low-dose cytarabine therapy. The three patients receiving 
      allo-SCT from unrelated or HLA-mismatched donors died of grade 3 to 4 acute GVHD 
      and infection within 5 months after transplantation. The estimated disease-free 
      survival at 4 years was 67% (95% confidence interval, 40-93%), and the overall 
      survival was 75% (95% confidence interval, 50-99%). Our data suggest that 
      allo-SCT should be considered early in the clinical course for young MDS patients 
      with a poor prognosis and a matched sibling donor.
FAU - Hsu, C
AU  - Hsu C
AD  - Bone Marrow Transplantation Unit, National Taiwan University Hospital, Taipei, 
      Taiwan.
FAU - Lin, M T
AU  - Lin MT
FAU - Tang, J L
AU  - Tang JL
FAU - Tien, H F
AU  - Tien HF
FAU - Wang, C H
AU  - Wang CH
FAU - Chen, Y C
AU  - Chen YC
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PL  - Singapore
TA  - J Formos Med Assoc
JT  - Journal of the Formosan Medical Association = Taiwan yi zhi
JID - 9214933
SB  - IM
MH  - Adult
MH  - Disease-Free Survival
MH  - Female
MH  - *Hematopoietic Stem Cell Transplantation
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myelodysplastic Syndromes/mortality/*therapy
MH  - Survival Rate
MH  - Taiwan/epidemiology
MH  - Transplantation Conditioning
EDAT- 1999/06/12 00:00
MHDA- 1999/06/12 00:01
CRDT- 1999/06/12 00:00
PHST- 1999/06/12 00:00 [pubmed]
PHST- 1999/06/12 00:01 [medline]
PHST- 1999/06/12 00:00 [entrez]
PST - ppublish
SO  - J Formos Med Assoc. 1999 Mar;98(3):157-64.