PMID- 25676424 OWN - NLM STAT- MEDLINE DCOM- 20150928 LR - 20181113 IS - 1476-5551 (Electronic) IS - 0887-6924 (Linking) VI - 29 IP - 7 DP - 2015 Jul TI - HLA-matched allogeneic stem cell transplantation improves outcome of higher risk myelodysplastic syndrome A prospective study on behalf of SFGM-TC and GFM. PG - 1496-501 LID - 10.1038/leu.2015.37 [doi] AB - Allogeneic hematopoietic stem cell transplantation (HSCT) is considered the only a curative treatment in patients with higher risk myelodysplastic syndrome (MDS), although demethylating agents (DMA) have been reported to improve survival. The advantage of HSCT over other treatment comes from retrospective studies and the aim of the current study was to prospectively test this hypothesis, analyzing in particular patients from the pre-transplant period to avoid the selection bias of performing transplantation. This study was conducted to compare overall survival in MDS patients candidates to transplantation according to donor availability. The majority of patients (76%) received a treatment with DMA after registration, 69% had a human leukocyte antigen (HLA)-identical donor, 70% of whom were transplanted. Baseline patient and disease characteristics were similar according to donor availability. Four-year overall survival was significantly better in patients with an HLA matched donor (37%) compared to patients without donor (15%). There was also evidence that this overall survival advantage was because of transplantation. Mortality risk was decreased after transplantation but it became significant only after the second year post transplant, because of early transplant-related mortality. Our results appear to justify, in higher risk MDS, a transplantation approach in all potential candidates who have an HLA identical donor. FAU - Robin, M AU - Robin M AD - 1] Hematologie - Transplantation; Assistance Publique Hopitaux de paris (AP-HP), Hopital Saint Louis, Paris, France [2] University Paris VII, Denis Diderot, Paris, France [3] Inserm U 1160, Paris, France. FAU - Porcher, R AU - Porcher R AD - 1] Team METHODS, Epidemiology and Statistics Sorbonne Paris Cite Research Centre UMR 1153, Inserm, Paris Descartes University, Paris, France [2] AP-HP, Hopital Hotel-Dieu, Centre d'Epidemiologie Clinique, Paris, France. FAU - Ades, L AU - Ades L AD - Hematologie senior, Assistance Publique Hopitaux de paris (AP-HP), Hopital Saint Louis and Hopital Avicenne, Paris, France. FAU - Raffoux, E AU - Raffoux E AD - Hematologie adulte, Assistance Publique Hopitaux de paris (AP-HP), Hopital Saint Louis, Paris, France. FAU - Michallet, M AU - Michallet M AD - Hematologie, CHU, Lyon, France. FAU - Francois, S AU - Francois S AD - Hematologie, CHU, Angers, France. FAU - Cahn, J-Y AU - Cahn JY AD - Hematologie, CHU,UMR 5525 CNRS-UJF, Grenoble, France. FAU - Delmer, A AU - Delmer A AD - Hematologie, CHU, Reims, France. FAU - Wattel, E AU - Wattel E AUID- ORCID: 0000000342541692 AD - Hematologie, CHU, Lyon, France. FAU - Vigouroux, S AU - Vigouroux S AD - Hematologie, CHU, Bordeaux, France. FAU - Bay, J-O AU - Bay JO AD - Hematologie, CHU, Clermont-Ferrand, France. FAU - Cornillon, J AU - Cornillon J AD - Hematologie, Institut de Cancerologie de la Loire, Saint-Etienne, France. FAU - Huynh, A AU - Huynh A AD - Hematologie, CHU, Toulouse, France. FAU - Nguyen, S AU - Nguyen S AD - Hematologie, hopital de La Pitie Salpetriere Assistance Publique Hopitaux de paris (AP-HP), Hopital Saint Louis, Paris, France. FAU - Rubio, M-T AU - Rubio MT AD - Hematologie, hopital Saint-Antoine, Assistance Publique Hopitaux de paris (AP-HP), Hopital Saint Louis, Paris, France. FAU - Vincent, L AU - Vincent L AD - Hematologie, CHU, Montpellier, France. FAU - Maillard, N AU - Maillard N AD - Hematologie, CHU, Poitiers, France. FAU - Charbonnier, A AU - Charbonnier A AD - Hematologie CHU, Amiens, France. FAU - de Latour, R P AU - de Latour RP AD - 1] Hematologie - Transplantation; Assistance Publique Hopitaux de paris (AP-HP), Hopital Saint Louis, Paris, France [2] University Paris VII, Denis Diderot, Paris, France [3] Inserm U 1160, Paris, France. FAU - Reman, O AU - Reman O AD - Hematologie CHU, Caen, France. FAU - Dombret, H AU - Dombret H AD - 1] University Paris VII, Denis Diderot, Paris, France [2] Hematologie senior, Assistance Publique Hopitaux de paris (AP-HP), Hopital Saint Louis and Hopital Avicenne, Paris, France. FAU - Fenaux, P AU - Fenaux P AD - 1] University Paris VII, Denis Diderot, Paris, France [2] Hematologie senior, Assistance Publique Hopitaux de paris (AP-HP), Hopital Saint Louis and Hopital Avicenne, Paris, France. FAU - Socie, G AU - Socie G AD - 1] Hematologie - Transplantation; Assistance Publique Hopitaux de paris (AP-HP), Hopital Saint Louis, Paris, France [2] University Paris VII, Denis Diderot, Paris, France [3] Inserm U 1160, Paris, France. LA - eng PT - Journal Article DEP - 20150213 PL - England TA - Leukemia JT - Leukemia JID - 8704895 RN - 0 (HLA Antigens) SB - IM MH - Aged MH - Antineoplastic Combined Chemotherapy Protocols/*therapeutic use MH - Combined Modality Therapy MH - Female MH - Follow-Up Studies MH - HLA Antigens/*immunology MH - Histocompatibility Testing MH - Humans MH - Male MH - Middle Aged MH - Myelodysplastic Syndromes/*immunology/mortality/pathology/*therapy MH - Neoplasm Staging MH - Prognosis MH - Prospective Studies MH - Retrospective Studies MH - Risk Factors MH - *Stem Cell Transplantation MH - Survival Rate MH - Transplantation Conditioning MH - Transplantation, Homologous EDAT- 2015/02/14 06:00 MHDA- 2015/09/29 06:00 CRDT- 2015/02/14 06:00 PHST- 2014/09/26 00:00 [received] PHST- 2014/11/26 00:00 [revised] PHST- 2014/12/01 00:00 [accepted] PHST- 2015/02/14 06:00 [entrez] PHST- 2015/02/14 06:00 [pubmed] PHST- 2015/09/29 06:00 [medline] AID - leu201537 [pii] AID - 10.1038/leu.2015.37 [doi] PST - ppublish SO - Leukemia. 2015 Jul;29(7):1496-501. doi: 10.1038/leu.2015.37. Epub 2015 Feb 13.