[Haploidentical hematopoietic stem cell transplantation for advanced myelodysplastic syndrome patients with recurrent...

Objective: To evaluate the efficacy of haploidentical hematopoietic stem cell transplantation (haplo-HSCT) in advanced myelodysplastic syndrome (MDS) patients with recurrent genetic abnormalities. Methods: We conducted a retrospective analysis of the clinical characteristics and prognosis of 14 advanced MDS patients with recurrent genetic abnormalities who underwent haplo-HSCT in the Hematology Department of Peking University People's Hospital from January 2015 to December 2020. The present study employed a 1∶4 propensity score matching method to select 56 contemporaneous advanced MDS patients without recurrent genetic abnormalities as the control group. The matching factors included age and disease stage (EB-1 or EB-2) . Results: The 5-year overall survival and disease-free survival after haplo-HSCT for MDS patients with and without recurrent genetic abnormalities were (64.3± 12.8) % vs (66.6±6.6) % (χ(2)=0.044, P=0.833) and (57.1±13.2) % vs (59.8±6.7) % (χ(2)=0.031, P=0.861) respectively. The 5-year cumulative non-relapse mortality rates after haplo-HSCT for MDS patients with and without recurrent genetic abnormalities were (21.4±11.5) % and (21.4±5.5) % (χ(2)=0.004, P=0.952), respectively; the relapse rates were (21.4±11.5) % and (16.1±5.0) % (χ(2)=0.096, P=0.757), respectively. Conclusion: These results suggest that the prognosis of MDS patients with recurrent genetic abnormalities is comparable to that of MDS patients without these abnormalities after haplo-HSCT. Haplo-HSCT may be an effective therapeutic option for advanced MDS patients with recurrent genetic abnormalities.