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Decision Analysis of Transplantation for Patients with Myelodysplasia: “Who Should We Transplant Today?”

  • Stem Cell Transplantation (R Maziarz, Section Editor)
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Abstract

Purpose of Review

Myelodysplastic syndrome (MDS) is a heterogeneous hematological disorder characterized by a spectrum of clinical presentation, cytogenetic, and somatic gene mutations and the risk of transformation to acute leukemia. Management options include observation, supportive care, blood transfusion, administration of growth factors and/or hypomethylating agents, and hematopoietic cell transplant (HCT) either upfront or after disease progression.

Recent Findings

Currently, HCT is the only curative therapy available for patients with MDS, with multiple factors such as donor availability, patient, and disease characteristics being involved in making the decision to proceed with transplant.

Summary

In this article, we summarize (1) overall prognosis and natural history of MDS, (2) currently available non-HCT therapy with a focus on hypomethylating agents (HMA), (3) outcomes after HCT in patients with MDS, (4) factors to be considered to proceed to HCT for treatment of MDS, and (5) more recent/ongoing studies relevant to HCT decision-making processes.

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Acknowledgments

The authors would like to thank Dr. Sally Mokhtari for critical review and assistance with editing this manuscript.

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  1. Department of Hematology & Hematopoietic Cell Transplant, City of Hope National Medical Center, Duarte, CA, 91010, USA

    Shukaib Arslan & Ryotaro Nakamura

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  1. Shukaib Arslan
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Correspondence to Ryotaro Nakamura.

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Arslan, S., Nakamura, R. Decision Analysis of Transplantation for Patients with Myelodysplasia: “Who Should We Transplant Today?”. Curr Hematol Malig Rep 15, 305–315 (2020). https://doi.org/10.1007/s11899-020-00573-6

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