British journal of haematology · 2026
Trends in survival outcomes after allogeneic transplantation for MDS and MDS/MPN in a real-world experience: A 25-year nationwide study.
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Itonaga Hidehiro, Miyazaki Yasushi, Tachi Noriaki, Kurosawa Shuhei, Marumo Atsushi, Konuma Takaaki, Ebina Toru, Doki Noriko, Uchida Naoyuki, Fukuda Takahiro, Nishida Tetsuya, Katayama Yuta, Asada Noboru, Sakurai Masatoshi, Maeda Takeshi, Eto Tetsuya, Tanaka Masatsugu, Nakamae Hirohisa, Onizuka Makoto, Kawamura Koji, Kanda Yoshinobu, Atsuta Yoshiko, Tachibana Takayoshi, adult MDS and CML/MPN working groups of the Japanese Society for Transplantation and Cellular Therapy
Аннотация
Allogeneic haematopoietic stem cell transplantation (allo-HSCT) offers a curative potential for myelodysplastic syndrome (MDS) and myelodysplastic/myeloproliferative neoplasm (MDS/MPN). We examined survival trends using a nationwide database of 7175 patients who underwent their first allo-HSCT between 1998 and 2022. Overall mortality decreased over time in patients with early MDS (hazard ratio [HR] 0.79, 95% confidence interval [CI] 0.65-0.97, p = 0.026 in 2013-2017; HR 0.54, 95% CI 0.42-0.70, p < 0.001 in 2018-2022), advanced MDS (HR 0.80, 95% CI 0.71-0.90, p < 0.001 in 2013-2017; HR 0.74, 95% CI 0.65-0.85, p < 0.001 in 2018-2022), chronic myelomonocytic leukaemia (HR 0.45, 95% CI 0.32-0.64, p < 0.001 in 2013-2017; HR 0.53, 95% CI 0.37-0.74, p < 0.001 in 2018-2022) and atypical chronic myeloid leukaemia (HR 0.32, 95% CI 0.13-0.80, p = 0.016 in 2013-2017; HR 0.26, 95% CI 0.10-0.68, p = 0.006 in 2018-2022). These decreases in overall mortality were mainly attributable to reductions in non-relapse mortality. Meanwhile, no significant difference in overall mortality was observed in patients with MDS/MPN-unclassified and therapy-related myeloid neoplasm. Across all disease subtypes, relapse incidence did not significantly decrease over time, highlighting persistent challenges in reducing the risk of post-transplant relapse.