Outcomes of second allogeneic haematopoietic stem cell transplantation in patients with relapse of myelodysplastic syndrome

Yoshimitsu Shimomura; Masahiko Hara; Takayoshi Tachibana; Kazuteru Ohashi; Toru Sakura; Takahiro Fukuda; Hideyuki Nakazawa; Koji Iwato; Yoshinobu Kanda; Takashi Ikeda; Tetsuya Eto; Junya Kanda; Tatsuo Ichinohe; Yoshiko Atsuta; Takayuki Ishikawa; Ken Ishiyama

doi:10.1111/bjh.15898

Outcomes of second allogeneic haematopoietic stem cell transplantation in patients with relapse of myelodysplastic syndrome

Br J Haematol. 2019 Jul;186(1):86-90. doi: 10.1111/bjh.15898. Epub 2019 Apr 2.

Authors

Yoshimitsu Shimomura¹, Masahiko Hara², Takayoshi Tachibana³, Kazuteru Ohashi⁴, Toru Sakura⁵, Takahiro Fukuda⁶, Hideyuki Nakazawa⁷, Koji Iwato⁸, Yoshinobu Kanda⁹, Takashi Ikeda¹⁰, Tetsuya Eto¹¹, Junya Kanda¹², Tatsuo Ichinohe¹³, Yoshiko Atsuta¹⁴, Takayuki Ishikawa¹, Ken Ishiyama¹⁵

Affiliations

¹ Department of Haematology, Kobe City Hospital Organization Kobe City Medical Centre General Hospital, Kobe, Japan.
² Centre for Community-based Healthcare Research and Education, Shimane University, Izumo, Japan.
³ Department of Haematology, Kanagawa Cancer Centre, Yokohama, Japan.
⁴ Haematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital, Tokyo, Japan.
⁵ Leukaemia Research Centre, Saiseikai Maebashi Hospital, Gunma, Japan.
⁶ Department of Haematopoietic Stem Cell Transplantation, National Cancer Centre Hospital, Tokyo, Japan.
⁷ Department of Haematology, Shinshu University School of Medicine, Nagano, Japan.
⁸ Department of Haematology, Hiroshima Red Cross Hospital & Atomic-bomb Survivors Hospital, Hiroshima, Japan.
⁹ Division of Haematology, Jichi Medical University Saitama Medical Centre, Saitama, Japan.
¹⁰ Division of Haematology and Stem Cell Transplantation, Shizuoka Cancer Centre, Shizuoka, Japan.
¹¹ Department of Haematology, Hamanomachi Hospital, Fukuoka, Japan.
¹² Department of Haematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
¹³ Department of Haematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan.
¹⁴ Japanese Data Centre for Haematopoietic Cell Transplantation, Aichi, Japan.
¹⁵ Department of Haematology, Kanazawa University Hospital, Kanazawa, Japan.

PMID: 30941758
DOI: 10.1111/bjh.15898

Abstract

Though second allogenic haematopoietic stem cell transplantation (HSCT) is considered a curative treatment option after myelodysplastic syndrome (MDS) relapse, scant epidemiological data are available. We investigated the outcomes and prognostic factors of second allogenic HSCT in 99 patients with MDS who relapsed after the first HSCT. The median age was 53 years (interquartile; 45-59) and 57 patients (57·6%) were male. Five-year overall survival was 25·3%. Early relapse (adjusted hazard ratio: 2·78, 95% confidence interval: 1·08-7·21, P = 0·035) and poor performance (3·03, 1·71-5·37, P < 0·001) were associated with a significantly poor 5-year overall survival compared to the other groups (P < 0·001).

Keywords: allogeneic haematopoietic stem cell transplantation; early relapse; myelodysplastic syndrome; performance status; second allogeneic haematopoietic stem cell transplantation.

MeSH terms

Female
Hematopoietic Stem Cell Transplantation / methods*
Hematopoietic Stem Cell Transplantation / mortality
Humans
Male
Middle Aged
Myelodysplastic Syndromes / diagnosis
Myelodysplastic Syndromes / mortality
Myelodysplastic Syndromes / pathology
Myelodysplastic Syndromes / therapy*
Prognosis
Recurrence
Reoperation / mortality*
Retrospective Studies
Risk Factors
Survival Analysis
Transplantation, Homologous
Treatment Outcome