PMID- 37156881
OWN - NLM
STAT- MEDLINE
DCOM- 20230807
LR  - 20230809
IS  - 1476-5365 (Electronic)
IS  - 0268-3369 (Print)
IS  - 0268-3369 (Linking)
VI  - 58
IP  - 8
DP  - 2023 Aug
TI  - Should a matched sibling donor still be considered the primary option for 
      allogeneic hematopoietic cell transplantation in patients over 50 years of age 
      with myelodysplastic syndrome?
PG  - 893-906
LID - 10.1038/s41409-023-01997-3 [doi]
AB  - Human leukocyte antigen (HLA)-matched sibling donors (MSDs) are the preferred 
      choice for allogeneic hematopoietic cell transplantation (HCT). However, as 
      myelodysplastic syndrome (MDS) is most frequently diagnosed in the elderly, MSDs 
      are also likely to be of advanced age. It is unclear whether an MSD should be 
      considered the primary choice for allogeneic HCT in elderly patients with MDS. We 
      retrospectively compared survival and other outcomes in 1787 patients with MDS 
      over 50 years of age and receiving allogeneic HCT between 2014 and 2020, using 
      either MSD (n = 214), 8/8 allele-matched unrelated donor (MUD) (n = 562), 7/8 
      allele-MUD (n = 334), or unrelated cord blood (UCB) (n = 677) in Japan. In 
      multivariate analysis, compared to MSD transplants, the risk of relapse was 
      significantly lower following 8/8MUD transplants (hazard ratio [HR], 0.74; 
      P = 0.047), whereas non-relapse mortality was significantly higher following UCB 
      transplants (HR, 1.43; P = 0.041). However, donor type did not determine overall 
      survival, disease-free survival, or graft-versus-host disease (GVHD)-free, 
      relapse-free survival, but chronic GVHD-free, relapse-free survival was better 
      after UCB (HR, 0.80; P = 0.025) and 8/8MUD (HR, 0.81; P = 0.032) compared to MSD 
      transplants. Our study demonstrated that MSDs are not superior to alternative HCT 
      methods, such as 8/8MUD, 7/8MUD, or UCB, in this population.
CI  - (c) 2023. The Author(s).
FAU - Konuma, Takaaki
AU  - Konuma T
AUID- ORCID: 0000-0002-1496-376X
AD  - Department of Hematology/Oncology, The Institute of Medical Science, The 
      University of Tokyo, Tokyo, Japan. tkonuma@ims.u-tokyo.ac.jp.
FAU - Itonaga, Hidehiro
AU  - Itonaga H
AD  - Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan.
FAU - Ishiyama, Ken
AU  - Ishiyama K
AUID- ORCID: 0000-0002-6189-0620
AD  - Department of Hematology, Kanazawa University, Kanazawa, Japan.
FAU - Doki, Noriko
AU  - Doki N
AD  - Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, 
      Komagome Hospital, Tokyo, Japan.
FAU - Uchida, Naoyuki
AU  - Uchida N
AUID- ORCID: 0000-0001-5952-5926
AD  - Department of Hematology, Toranomon Hospital, Tokyo, Japan.
FAU - Sawa, Masashi
AU  - Sawa M
AD  - Department of Hematology and Oncology, Anjo Kosei Hospital, Anjo, Japan.
FAU - Katayama, Yuta
AU  - Katayama Y
AUID- ORCID: 0000-0001-5054-9104
AD  - Department of Hematology, Hiroshima Red Cross Hospital & Atomic-Bomb Survivors 
      Hospital, Hiroshima, Japan.
FAU - Tanaka, Masatsugu
AU  - Tanaka M
AD  - Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan.
FAU - Ueda, Yasunori
AU  - Ueda Y
AD  - Department of Hematology/Oncology and Transfusion and Hemapheresis Center, 
      Kurashiki Central Hospital, Kurashiki, Japan.
FAU - Onizuka, Makoto
AU  - Onizuka M
AUID- ORCID: 0000-0003-3864-0823
AD  - Department of Hematology and Oncology, Tokai University School of Medicine, 
      Isehara, Japan.
FAU - Miyakoshi, Shigesaburo
AU  - Miyakoshi S
AD  - Department of Hematology, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan.
FAU - Ozawa, Yukiyasu
AU  - Ozawa Y
AD  - Department of Hematology, Japanese Red Cross Nagoya First Hospital, Nagoya, 
      Japan.
FAU - Fukuda, Takahiro
AU  - Fukuda T
AD  - Hematopoietic Stem Cell Transplantation Division, National Cancer Hospital, 
      Tokyo, Japan.
FAU - Matsuoka, Ken-Ichi
AU  - Matsuoka KI
AUID- ORCID: 0000-0001-7955-8266
AD  - Department of Hematology and Oncology, Okayama University Hospital, Okayama, 
      Japan.
FAU - Tanaka, Junji
AU  - Tanaka J
AD  - Department of Hematology, Tokyo Women's Medical University, Tokyo, Japan.
FAU - Kimura, Takafumi
AU  - Kimura T
AD  - Preparation Department, Japanese Red Cross Kinki Block Blood Center, Osaka, 
      Japan.
FAU - Ichinohe, Tatsuo
AU  - Ichinohe T
AUID- ORCID: 0000-0002-0393-4066
AD  - Department of Hematology and Oncology, Research Institute for Radiation Biology 
      and Medicine, Hiroshima University, Hiroshima, Japan.
FAU - Atsuta, Yoshiko
AU  - Atsuta Y
AUID- ORCID: 0000-0003-4404-2870
AD  - Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan.
AD  - Department of Registry Science for Transplant and Cellular Therapy, Aichi Medical 
      University School of Medicine, Nagakute, Japan.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20230508
PL  - England
TA  - Bone Marrow Transplant
JT  - Bone marrow transplantation
JID - 8702459
SB  - IM
MH  - Humans
MH  - Middle Aged
MH  - Aged
MH  - Retrospective Studies
MH  - Siblings
MH  - *Hematopoietic Stem Cell Transplantation/methods
MH  - Tissue Donors
MH  - *Myelodysplastic Syndromes/therapy
MH  - *Graft vs Host Disease/etiology
MH  - Recurrence
MH  - Unrelated Donors
MH  - Transplantation Conditioning/methods
PMC - PMC10400426
COIS- The authors declare no competing interests.
EDAT- 2023/05/09 00:42
MHDA- 2023/08/07 06:41
PMCR- 2023/05/08
CRDT- 2023/05/08 23:21
PHST- 2023/02/23 00:00 [received]
PHST- 2023/04/19 00:00 [accepted]
PHST- 2023/04/13 00:00 [revised]
PHST- 2023/08/07 06:41 [medline]
PHST- 2023/05/09 00:42 [pubmed]
PHST- 2023/05/08 23:21 [entrez]
PHST- 2023/05/08 00:00 [pmc-release]
AID - 10.1038/s41409-023-01997-3 [pii]
AID - 1997 [pii]
AID - 10.1038/s41409-023-01997-3 [doi]
PST - ppublish
SO  - Bone Marrow Transplant. 2023 Aug;58(8):893-906. doi: 10.1038/s41409-023-01997-3. 
      Epub 2023 May 8.