异基因造血干细胞移植治疗骨髓增生异常综合征的预后因素分析

OBJECTIVE: To evaluate the outcomes and prognostic factors of myelodysplasia syndrome (MDS) patients who received allogeneic hematopoietic stem cell transplantation (allo-HSCT). METHODS: 165 cases of MDS who underwent allo-HSCT from Jan. 2010 to Mar. 2018 were analyzed retrospectively, focusing on the overall survival (OS), disease free survival (DFS), relapse, non-relapse mortality (NRM) and their related risk factors. RESULTS: Of all the 165 cases, 105 were male and 60 were female. The 3-year OS and DFS rate were 72.5% (95%CI 64.9%–80.1%) and 67.4% (95%CI 59.17%–75.63%), respectively. The 3-year cumulative incidence of relapse and NRM were 12.11% (95%CI 7.03%–18.65%) and 20.44% (95%CI 14.15%–27.56%), respectively. HCT-comorbidity index (P=0.042, HR=2.094, 95%CI 1.026–4.274) was identified as independent risk factor for OS by the multivariate analysis. Intensive chemotherapy before HSCT or hypomethylation agents treatment had no effects on OS[ (67.0±7.5) %vs (57.7±10.9) %, χ(2)=0.025, P=0.874]. CONCLUSION: allo-HSCT is a promising means for MDS, and NRM is the major cause of treatment failure. MDS with refractory anemia with excess blasts and secondary acute myeloid leukemia patients may not benefit from intensive chemotherapy or hypomethylation agents treatment before HSCT.