Allogeneic hematopoietic stem cell transplantation for myelodysplastic syndrome: indications and controversy of pre-transplant chemotherapy / 白血病·淋巴瘤

ABSTRACT

The indications for myelodysplastic syndrome (MDS) to receive allogeneic hematopoietic stem cell transplantation (allo-HSCT) were established on the basis of FAB diagnosis,International Prognosis Scoring System (IPSS) and World Health Organization Prognosis Scoring System (WPSS).It was recommended that patients of IPSS intermediate risk Ⅱ and of high risk should receive allo-HSCT at diagnosis,and those with intermediate risk Ⅰ and of low risk might benefit from deferred transplantation.Dynamic monitoring of marrow morphology and the risk of disease are needed for appropriate timing of transplant.Patients of intermediate risk and low risk with low platelet count,pneutropenia or blood infusion dependence are indicated for transplantation.The advantage of chemotherapy pre-HSCT in those indicated patients has been controversial.Up to now,there has been few data showing benefit of pre-chemotherapy or hypomethylating therapy.