Sequential versus standard conditioning in untreated MDS patients with blasts undergoing allogeneic HSCT

Myelodysplastic syndromes Myelodysplastic syndromes: (my-eh-lo-diss-PLASS-tik SIN-dromez) A group of disorders where the bone marrow does not work well, and the bone marrow cells fail to make enough healthy blood cells. Myelo refers to the bone marrow. Dysplastic means abnormal growth or development. People with MDS have low blood cell count for at… (MDS) can progress to AML and often require allogeneic hematopoietic stem cell transplantation (allo-SCT). The sequential FLAMSA-FB regimen, featuring a cytoreductive FLAMSA phase followed by fludarabine fludarabine: The U.S. Food and Drug Administration (FDA) approved fludarabine for treating chronic lymphocytic leukemia (CCL). Researchers are studying fludarabine in combination with other medicines for treating bone marrow failure. -busulfan (FB) conditioning, may enhance disease control. We retrospectively analyzed 106 untreated MDS patients with blasts blasts: See Blast Cells. 5-19% at the University Medical Center Hamburg who received either FLAMSA-FB (n = 45) or standard conditioning (n = 61: Thiotepa-Busulfan (n = 30), Fludarabine-Busulfan (n = 16), Treosulfan-Fludarabine (n = 15)). Median follow-up was 24 months. The FLAMSA group was younger (median age 56 vs. 62, p = 0.02), but baseline IPSS risk scores (p = 0.16) and donor types (p = 0.43) were comparable. Engraftment Engraftment: Refers to how well a graft (donor cells) is accepted by the host (the patient) after a bone marrow or stem cell transplant. Several factors contribute to better engraftment - physical condition of the patient, how severe the disease is, type of donor available, age of patient. Successful… rates were similar. At two years, overall survival (OS) was 62% with FLAMSA and 68% with standard conditioning (p = 0.92), while progression-free survival (PFS) was 56% vs. 59% (p = 0.92). Non-relapse mortality (22% vs. 25%, p = 0.78) and cumulative incidence of relapse (22% vs. 13%, p = 0.12) did not differ significantly, nor did grade II-IV acute graft-versus-host disease (GVHD) graft-versus-host disease (GVHD): Also called GVHD, it is a common complication of bone marrow/stem cell transplantation. It is caused when the donor's immune cells, now in the patient, begin to see the the patient's body as foreign and mount an immune response. GVHD most commonly effects the recipient's skin, intestines, or liver… . Propensity score matching in 18 pairs confirmed no significant differences in OS, PFS, NRM, or CIR. However, moderate-to-severe chronic GVHD was higher with FLAMSA-FB (50% vs. 17%, p = 0.04). Thus, FLAMSA-FB did not improve transplant outcomes over standard conditioning but was linked to an increased risk of chronic GVHD.