Stem Cell Transplantation for Myelodysplasia
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.
KeywordsStem Cell Transplantation Myelodysplastic Syndrome Donor Lymphocyte Infusion International Prognostic Score System Transplant Related Mortality
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