Clinical Hospital, Department of Surgery, Federal University of Ceara, Fortaleza, Brazil.
Hematology Research Laboratory, Federal University of Ceara, Fortaleza, Brazil.
Biol Blood Marrow Transplant. 2020 May;26(5):1021-1024. doi: 10.1016/j.bbmt.2020.01.030. Epub 2020 Feb 27.
It has been suggested that bridging therapy with intensive chemotherapy and/or hypomethylating agents followed by hematopoietic stem cell transplantation (HSCT) can be valuable in the treatment of patients with myelodysplastic syndromes (MDS). However, the influence of this approach on HSCT outcomes remains poorly defined. Therefore, our objective was to investigate the influence of treatment before HSCT in patients with MDS. We retrospectively analyzed data from the Latin American registry of 258 patients from 17 Latin American centers who underwent HSCT from 1988 to 2019. Our data showed that there was pre-HSCT. We detected no significant difference regarding the impact on overall survival of treated and untreated patients before HSCT. Despite these data, the type of previous treatment among treated patients showed a significant difference in overall survival. Treatment with hypomethylating agents together with pre-HSCT chemotherapy seems to result in better survival of the studied population. These data correspond to the first results obtained through cooperative work between various centers in Latin America comparing the different approaches to patients and reflecting their reality and challenges. Therefore, the selection of pretransplant bridge therapy should be analyzed and focus given primarily to those approaches that result in better survival of patients with MDS.
有人认为,桥接治疗联合强化化疗和/或低甲基化药物治疗,随后进行造血干细胞移植(HSCT),对治疗骨髓增生异常综合征(MDS)患者可能具有重要价值。然而,这种方法对 HSCT 结果的影响仍未得到明确界定。因此,我们的目的是研究 MDS 患者 HSCT 前治疗的影响。我们回顾性分析了来自 17 个拉丁美洲中心的 258 例患者的数据,这些患者于 1988 年至 2019 年期间接受了 HSCT。我们的数据显示,HSCT 前存在治疗情况。我们发现,HSCT 前接受治疗和未接受治疗的患者的总体生存率没有显著差异。尽管存在这些数据,但在接受治疗的患者中,先前治疗的类型在总体生存率方面存在显著差异。在 HSCT 前接受低甲基化药物联合化疗治疗的患者似乎具有更好的生存结果。这些数据是通过拉丁美洲多个中心之间的合作获得的首批结果之一,比较了患者的不同治疗方法,反映了他们的实际情况和面临的挑战。因此,应分析 HSCT 前桥接治疗的选择,并主要关注那些能改善 MDS 患者生存的治疗方法。