VIDEO: HCT improves survival in older patients with advanced myelodysplastic syndrome
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Allogeneic hematopoietic cell transplantation improved overall survival and leukemia-free survival in patients aged 50 to 75 years with high-risk myelodysplastic syndrome, according to data presented at ASH Annual Meeting and Exposition.
At 3 years, older adults in the donor arm had significantly better outcomes compared with those in the no-donor arm by about 20%, Corey Cutler, MD, MPH, FRCPC, medical director of the Adult Stem Cell Transplantation Program at Dana-Farber Cancer Institute, told Healio in a video interview. There was also a leukemia-free survival advantage for individuals who had a suitable stem cell donor and who were candidates for transplantation.
Cutler said outcomes from this biologic assignment study were even more marked in the as-treated analysis and the advantages for patients who underwent transplant with matched, related/unrelated donors were superior by more than 25% in 3 years compared with those in the no-donor arm who did not undergo alternative donor transplant.
“The main take-home points are that individuals who are above the age of 50 and are deemed to be candidates for transplantation should be seen at a transplant center early to determine their true candidacy and so we can get a donor search started very early,” Cutler said. “Overall, individuals who end up having a donor for transplantation do fare better in the long-term and therefore transplantation for these individuals should really be considered the standard of care.”
An ongoing cost-effectiveness analysis is underway, Cutler said. Currently, transplantation for higher-risk MDS among older individuals is not a covered Medicare service, so he hopes this trial will help change the coverage determination.
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Cutler C, et al. Abstract 75. Presented at: ASH Annual Meeting and Exposition (virtual meeting); Dec. 5-8, 2020.
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