Minimal Identifiable Disease and the Role of Conditioning Intensity in Hematopoietic Cell Transplantation for Myelodysplastic Syndrome and Acute Myelogenous Leukemia Evolving from Myelodysplastic Syndrome

摘要: Allogeneic hematopoietic cell transplantation (HCT) is the only known treatment with curative potential for myelodysplastic syndrome, but relapse a major cause of failure. We studied results in 289 patients transplanted between June 2004 and December 2013. Minimal identifiable disease (MID) markers pre-HCT were determined by multiparameter flow cytometry (MFC) cytogenetics on marrow aspirates. The impact MID outcome after low- high-intensity conditioning HCT was determined. Among 287 assessable patients, 68 (23.7%) had more than 5% blasts at HCT; 219 morphologic remission 154 (53.7%) positive, whereas 65 (22.6%) negative. significantly different who received low-intensity regimen. intensity differed across various categories. In particular, risk overall mortality higher regimens positive regardless positivity MFC (HR, 1.67 if positive/cytogenetics HR, 7.23 negative/cytogenetics positive). On other hand, negative both similar risks .99). main factor responsible MID-positive relapse. presence should be considered when deciding because it identifies subgroups may benefit from high- or conditioning.