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Stem Cell Transplantation for Myelodysplasia

  • Hans-G. Klingemann
  • H. Joachim Deeg
Part of the Cancer Treatment and Research book series (CTAR, volume 108)

Abstract

The natural course of MDS varies considerably depending upon patient age and findings at the time of diagnosis. Life expectancy ranges from years in early stages to only a few months in advanced stages. The disease can rapidly progress to acute leukemia, and the prognosis for patients with advanced MDS (RAEB, RAEBT) and therapy-related (secondary) MDS is generally less than 12 months. CMML generally referred to as MDS has recently been reclassified as a myeloproliferative disorder (MPD), although myelodysplastic features are usually present. The median survival is 8–30 months. Since most transplant studies for MDS include CMML, this review will consider CMML as well. While patients with RA or RARS may fair well with conventional treatment, they frequently require transfusion support with red blood cells and platelets which results in iron overload and allosensitization. Prolonged neutropenia may facilitate infections which can significantly increase the risk of post-transplant complications.

Keywords

Stem Cell Transplantation Myelodysplastic Syndrome Donor Lymphocyte Infusion International Prognostic Score System Transplant Related Mortality 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. Anderson, J.E., Appelbaum, F.R., Schoch, G., Gooley, T., Anasetti, C., Bensinger, W.I., Bryant, E., Dean Buckner, C, Chauncey, T, Clift, R.A., Doney, K., Flowers, M., Hansen, J.A., Martin, P.J., Matthews, D.C., Sanders, J.E., Shulman, H., Sullivan, K.M., Witherspoon, R.P., & Storb, R. (1996a) Allogeneic Marrow Transplant for Refractory Anemia: A comparison of two preparative regimens and analysis of prognostic factors.Blood87, 51–58.Google Scholar
  2. Anderson, J.E., Appelbaum, F.R., Schoch, G., Gooley, T., Anasetti, C., Bensinger, W.I., Bryant, E., Dean Buckner, C, Chauncey, T, Clift, R.A., Joachim Deeg, H., Doney, K., Flowers, M., Hansen, J.A., Martin, P.J., Matthews, D.C., Nash, R.A., Sanders, J.E., Shulman, H., Sullivan, K.M., Witherspoon, R.P., & Storb, R. (1996b) Allogeneic marrow transplantation for myelodysplastic syndrome with advanced disease morphology: A phase 11 study of Busulfan, Cyclophosphamide, and total-body irradiation and analysis of prognostic factors.Journal of Clinical Oncology14, 220–226.Google Scholar
  3. AppeLbaum, F., & Anderson, J. (1998) Allogeneic bone marrow transplantation for myelodysplastic syndrome: outcomes analysis according to IPSS score.Leukemia12, Supplement 1, S25–S29.Google Scholar
  4. Ballen, K.K., Gilliland, D.G., Guinan, E.C., Hsieh, C-C., Parsons, S.K., Rimm, I.J., Ferrara, J.L.M., Bierer, B.E., Weinstein, H.J., & Antin, J.H. (1997) Bone marrow transplantation for therapy-related myelodysplasia: comparison with primary myelodysplasia.Bone Marrow Transplantation20, 737–743.PubMedCrossRefGoogle Scholar
  5. Deeg, H.J., Shulman, H.M., Anderson, J.E., Bryant, E.M., Gooley, T.A., Slattery, J.T., Anasetti, C., Fefer, A., Storb, R., & Appelbaum, F.R. (2000) Allogeneic and syngeneic marrow transplantation for myelodysplastic syndrome in patients 55 to 66 years of age.Blood95, 1188–1194PubMedGoogle Scholar
  6. Friedberg, J.W., Neuberg, D., Stone, R.M., Alyea, E., Jallow, H., LaCasce, A., Mauch, P.M., Gribben, J.G., Ritz, J., Nadler, L.M., Soiffer, R.J., & Freedman, A.S. (1999) Outcome in patients with myelodysplastic syndrome after autologous bone marrow transplantation for non-Hodgkin’s lymphoma.Journal of Clinical Oncology17, 3128–3135.PubMedGoogle Scholar
  7. Gassmann, W., Schmitz, N., Loftier, H., & DeWitte, T. (1996) Intensive chemotherapy and bone marrow transplantation for myelodysplastic syndromes.Seminars in Hematology33, 196–205.PubMedGoogle Scholar
  8. Okamoto, S., Takahashi, S., Wakui, M., Ishida, A., Tanosaki, R., Ikeda, Y., & Asano, S. (1999) Treatment of advanced myelodysplastic syndromes with a regimen including recombinant human granulocyte colony-stimulating factor preceding allogeneic bone marrow transplantation.British Journal of Haematology 104:569–573.PubMedCrossRefGoogle Scholar
  9. Porter, D.L., Roth, M.S., Lee, S.J., McGarigle, C., Ferrara, J.L.M., & Antin, J.H. (1996) Adoptive immunotherapy with donor mononuclear cell infusions to treat relapse of acute leukemia or myelodysplasia after allogeneic bone marrow transplantation.Bone Marrow Transplantation 18975–980PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2001

Authors and Affiliations

  • Hans-G. Klingemann
    • 1
  • H. Joachim Deeg
    • 2
  1. 1.Section of Bone Marrow Transplant and Cell Therapy at RUSH Cancer InstituteChicago
  2. 2.Fred Hutchinson Cancer Research CenterSeattle

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