Wu Bing, Wei Yan, Zhang Qian
Institute of Hematological Diseases, Lanzhou Military Area General Hospital, Lanzhou, Gansu Province, China.
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2012 Apr;20(2):510-3.
Hematopoietic stem cell transplantation (HSCT) is the only way to cure myelodysplastic syndromes. At present there are several myelodysplastic syndromes scoring systems, including the International Prognostic Scoring System (IPSS), WHO Prognostic Scoring System (WPSS) and Simplified MDS Risk Score. These score systems can not only predict the probability of transplant success, but also help to determine the time of transplantation. For the older patient with serious complication, a suitable conditioning regimen can lower the risk of treatment-related mortality. Complication management, individualized conditioning regimen, optimal timing of transplantation and donor selection should improve the curative effect of HSCT. However, post-transplantation relapse and graft-versus-host disease (GVHD) remain to be solved and further investigations are needed. In this review the MDS scoring system, factors influencing HSCT efficacy, the selection of HSCT donors and timing, the preconditioning intensity before HSCT and evaluation of HSCT efficacy are summarized.
造血干细胞移植（HSCT）是治愈骨髓增生异常综合征的唯一方法。目前有多种骨髓增生异常综合征评分系统，包括国际预后评分系统（IPSS）、世界卫生组织预后评分系统（WPSS）和简化的MDS风险评分。这些评分系统不仅可以预测移植成功的概率，还有助于确定移植时间。对于有严重并发症的老年患者，合适的预处理方案可以降低治疗相关死亡率。并发症管理、个体化预处理方案、最佳移植时机和供体选择应能提高HSCT的疗效。然而，移植后复发和移植物抗宿主病（GVHD）仍有待解决，需要进一步研究。本文综述了MDS评分系统、影响HSCT疗效的因素、HSCT供体的选择和时机、HSCT前的预处理强度以及HSCT疗效评估。
