TY - JOUR
T1 - Myeloablative versus Reduced-Intensity Hematopoietic Cell Transplantation in Myelodysplastic Syndromes
T2 - Systematic Review and Meta-analysis
AU - Rashidi, Armin
AU - Meybodi, Mohamad A.
AU - Cao, Wenhao
AU - Chu, Haitao
AU - Warlick, Erica D.
AU - Devine, Steven
AU - Pasquini, Marcelo C.
AU - Weisdorf, Daniel J.
AU - Hamadani, Mehdi
PY - 2020/6
Y1 - 2020/6
N2 - In a systematic review and meta-analysis, we compared allogeneic transplant outcomes after myeloablative conditioning (MAC) versus reduced-intensity conditioning (RIC) in patients with myelodysplastic syndromes. Only 2 published randomized clinical trials were found, with a pooled sample size of 183 (RIC, 92; MAC, 91). Both studies suggested an overall survival advantage after RIC, with a pooled hazard ratio (HR) of. 67 (95% confidence interval [CI],. 41 to 1.09) for RIC versus MAC. Relapse results were also concordant, with a pooled HR of 1.55 (95% CI,. 74 to 3.25) for RIC versus MAC. Neither result was statistically significant. Comparisons for other outcomes were unremarkable. In conclusion, the evidence for the optimal conditioning intensity in myelodysplastic syndromes is weak. Post-transplant maintenance strategies and incorporation of genomic information into decision-making may improve post-transplant outcomes.
AB - In a systematic review and meta-analysis, we compared allogeneic transplant outcomes after myeloablative conditioning (MAC) versus reduced-intensity conditioning (RIC) in patients with myelodysplastic syndromes. Only 2 published randomized clinical trials were found, with a pooled sample size of 183 (RIC, 92; MAC, 91). Both studies suggested an overall survival advantage after RIC, with a pooled hazard ratio (HR) of. 67 (95% confidence interval [CI],. 41 to 1.09) for RIC versus MAC. Relapse results were also concordant, with a pooled HR of 1.55 (95% CI,. 74 to 3.25) for RIC versus MAC. Neither result was statistically significant. Comparisons for other outcomes were unremarkable. In conclusion, the evidence for the optimal conditioning intensity in myelodysplastic syndromes is weak. Post-transplant maintenance strategies and incorporation of genomic information into decision-making may improve post-transplant outcomes.
KW - Meta-analysis
KW - Myeloablative
KW - Myelodysplastic syndromes
KW - Reduced intensity
KW - Transplantation
UR - http://www.scopus.com/inward/record.url?scp=85083504564&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85083504564&partnerID=8YFLogxK
U2 - 10.1016/j.bbmt.2020.03.003
DO - 10.1016/j.bbmt.2020.03.003
M3 - Article
C2 - 32171885
AN - SCOPUS:85083504564
VL - 26
SP - e138-e141
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
SN - 1083-8791
IS - 6
ER -