Second allogeneic transplant for MDS – pro
As a result of the lack of well-established data, the management of patients relapsing after allo-HSCT is challenging and consists of many disparate strategies. Several studies have addressed the issue of post-transplant relapse in MDS patients.
Except in cases where palliative or supportive care is the only feasible option, cytoreductive treatment (CRT), using either DMAs or induction-type chemotherapy, has been used with differing degrees of success, as well as immunotherapeutic strategies, with donor lymphocyte infusion (DLI) or second allo-HSCT, either alone or in combination with CRT. None of these approaches are backed by sufficient studies or experience and should still, except for palliative care, including drug palliative therapy, would be considered E?I.
RomainGuièze et al, Management of Myelodysplastic Syndrome Relapsing after Allogeneic Hematopoietic Stem Cell Transplantation: A Study by the French Society of Bone Marrow Transplantation and Cell Therapies. Biology of Blood and Marrow Transplantation
M. Ikeda et al Successful Second Allogeneic Stem Cell Transplantation From a Sibling Donor for Relapse of Myelodysplastic Syndrome in a Recipient of a Renal Transplant From His Mother: Case ReportTransplantation Proceedings. Volume 48, Issue 9, November 2016, Pages 3085-3087
Koji Kato, Toshihiro Miyamoto, Koji Yonemoto, Naoyuki Uchida, Hiroyasu Ogawa, Takahiro Fukuda, Satoshi Takahashi, Kazuteru Ohashi, Tetsuya Eto, Tokiko Nagamura-Inoue, Hisashi Sakamaki, Yasuo Morishima, Ritsuro Suzuki, Yoshiko Atsuta and Koichi Akashi et al, Second Allogeneic Hematopoietic Stem Cell Transplantation (allo-HSCT) for Relapse of Hematological Malignancies after First Allo-HSCT. Blood 2014 124:3947;