Current challenges in conditioning regimens for MDS transplantation.
Fiche publication
Date publication
juillet 2024
Journal
Blood reviews
Auteurs
Membres identifiés du Cancéropôle Est :
Dr D'AVENI-PINEY Maud
Tous les auteurs :
Notarantonio AB, Robin M, D'Aveni M
Lien Pubmed
Résumé
Myelodysplastic syndrome (MDS) is a very heterogeneous clonal disorder. Patients with "higher-risk" MDS, defined by specific recurrent genetic abnormalities, have a poor prognosis because of a high risk of progression to secondary acute myeloid leukemia with low chemosensitivity. Allogeneic hematopoietic stem cell transplantation remains the only treatment that offers durable disease control because the donor immune system allows graft-versus-MDS effects. In terms of preparation steps before transplantation, targeting the malignant clone by increasing the conditioning regimen intensity is still a matter of intense debate. MDS is mainly diagnosed in older patients, and high toxicity related to common myeloablative conditioning regimens has been reported. Efforts to include new drugs in the conditioning regimen to achieve the best malignant clone control without increasing toxicity have been made over the past 20 years. We summarized these retrospective and prospective studies and evaluated the limitations of the available evidence to delineate the ideal conditioning regimen.
Mots clés
Allogeneic stem cell transplantation, Conditioning intensity, Myelodysplastic syndromes
Référence
Blood Rev. 2024 07 10;:101223