Medizinische Klinik I, Universitätsklinikum Carl-Gustav-Carus, Fetscherstraße 74, 01307, Dresden, Germany,
Curr Hematol Malig Rep. 2013 Dec;8(4):379-85. doi: 10.1007/s11899-013-0181-2.
Allogeneic hematopoietic stem cell transplantation (HCT) is still the only treatment modality with curative potential for patients with myelodysplastic syndromes. While early transplant-related mortality has improved during the last years, relapse risk following HCT still remains high, especially in older patients undergoing reduced-intensity conditioning. Therefore, when considering allogeneic HCT, in the absence of randomized data, emphasis should be put on patient selection and optimization of the pre-transplant and post-transplant period. In addition to a thorough comorbidity evaluation, risk stratification considering age, cytogenetics, grade of cytopenia, disease-related quality of life, as well as discussion of available treatment alternatives, are mandatory to decide when and how to perform allogeneic HCT. Since therapeutic options are often limited in patients relapsing after HCT, preventing relapse through maintenance strategies or minimal residual disease-directed therapy remains a central goal of current clinical research.
异基因造血干细胞移植（HCT）仍然是治疗骨髓增生异常综合征患者的唯一有治愈潜力的治疗方法。尽管近年来早期与移植相关的死亡率有所改善，但 HCT 后复发的风险仍然很高，尤其是在接受低强度预处理的老年患者中。因此，在考虑异基因 HCT 时，在没有随机数据的情况下，应重点关注患者选择以及移植前和移植后的优化。除了彻底的合并症评估外，还必须进行风险分层，考虑年龄、细胞遗传学、血细胞减少程度、疾病相关生活质量，以及讨论可用的治疗替代方案，以决定何时以及如何进行异基因 HCT。由于治疗选择在 HCT 后复发的患者中往往有限，因此通过维持策略或微小残留病灶导向治疗来预防复发仍然是当前临床研究的核心目标。
