Abstract

Allogeneic hematopoietic stem cell transplantation (HSCT) is the only potentially curative option for patients with high-risk myelodysplastic syndromes (MDS). Advances in conditioning regimens and supportive measures have reduced treatment-related mortality and increased the role of transplantation, leading to more patients undergoing HSCT. However, posttransplant relapse of MDS remains a leading cause of morbidity and mortality for this procedure, necessitating expert management and ongoing results analysis. In this article, we review treatment options and our institutional approaches to managing MDS relapse after HSCT, using illustrative clinical cases that exemplify different clinical manifestations and management of relapse. We address areas of controversy relating to conditioning regimen intensity, chemotherapeutic bridging, and donor selection. In addition, we discuss future directions for advancing the field, including (1) the need for prospective clinical trials separating MDS from acute myeloid leukemia and focusing on posttransplant relapse, as well as (2) the validation of measurable residual disease methodologies to guide timely interventions.

1.
Cancer Statistics Review SEER
.
1975-2017: myelodysplastic syndromes (MDS), chronic myeloproliferative disorders (CMD), and chronic myelomonocytic leukemia (CMML)
. https://seer.cancer.gov/archive/csr/1975_2017/results_merged/sect_30_mds.pdf.
2.
Fenaux
P
,
Platzbecker
U
,
Ades
L
.
How we manage adults with myelodysplastic syndrome
.
Br J Haematol
.
2020
;
189
(
6
):
1016
-
1027
.
3.
Bernard
E
,
Tuechler
H
,
Greenberg
PL
, et al
.
Molecular international prognostic scoring system for myelodysplastic syndromes
.
NEJM Evidence
.
2022
;
1
(
7
):
EVIDoa2200008
.
4.
Papaemmanuil
E
,
Gerstung
M
,
Malcovati
L
, et al
.
Clinical and biological implications of driver mutations in myelodysplastic syndromes
.
Blood
.
2013
;
122
(
22
):
3616
-
3699
.
5.
Sallman
DA
,
Tanaka
TN
,
List
A
,
Bejar
R
.
SOHO state of the art update and next questions: biology and treatment of myelodysplastic syndromes
.
Clin Lymphoma Myeloma Leuk
.
2017
;
17
(
10
):
613
-
620
.
6.
Greenberg
P
,
Cox
C
,
LeBeau
MM
, et al
.
International scoring system for evaluating prognosis in myelodysplastic syndromes
.
Blood
.
1997
;
89
(
6
):
2079
-
2088
.
7.
Malcovati
L
,
Germing
U
,
Kuendgen
A
, et al
.
Time-dependent prognostic scoring system for predicting survival and leukemic evolution in myelodysplastic syndromes
.
J Clin Oncol
.
2007
;
25
(
23
):
3503
-
3510
.
8.
Greenberg
PL
,
Tuechler
H
,
Schanz
J
, et al
.
Revised international prognostic scoring system for myelodysplastic syndromes
.
Blood
.
2012
;
120
(
12
):
2454
-
2465
.
9.
Fenaux
P
,
Mufti
GJ
,
Hellstrom-Lindberg
E
, et al
.
Efficacy of azacitidine compared with that of conventional care regimens in the treatment of higher-risk myelodysplastic syndromes: a randomised, open-label, phase III study
.
Lancet Oncol
.
2009
;
10
(
3
):
223
-
232
.
10.
Kantarjian
HM
,
Thomas
XG
,
Dmoszynska
A
, et al
.
Multicenter, randomized, open-label, phase III trial of decitabine versus patient choice, with physician advice, of either supportive care or low-dose cytarabine for the treatment of older patients with newly diagnosed acute myeloid leukemia
.
J Clin Oncol
.
2012
;
30
(
21
):
2670
-
2677
.
11.
Merlevede
J
,
Droin
N
,
Qin
T
, et al
.
Mutation allele burden remains unchanged in chronic myelomonocytic leukaemia responding to hypomethylating agents
.
Nat Commun
.
2016
;
7
:
10767
.
12.
Craddock
C
,
Quek
L
,
Goardon
N
, et al
.
Azacitidine fails to eradicate leukemic stem/progenitor cell populations in patients with acute myeloid leukemia and myelodysplasia
.
Leukemia
.
2013
;
27
(
5
):
1028
-
1036
.
13.
Nakamura
R
,
Saber
W
,
Martens
MJ
, et al
.
Biologic assignment trial of reduced-intensity hematopoietic cell transplantation based on donor availability in patients 50-75 years of age with advanced myelodysplastic syndrome
.
J Clin Oncol
.
2021
;
39
(
30
):
3328
-
3339
.
14.
Kröger
N
,
Sockel
K
,
Wolschke
C
, et al
.
Comparison between 5-azacytidine treatment and allogeneic stem-cell transplantation in elderly patients with advanced MDS according to donor availability (VidazaAllo Study)
.
J Clin Oncol
.
2021
;
39
(
30
):
3318
-
3327
.
15.
Lim
Z
,
Brand
R
,
Martino
R
, et al
.
Allogeneic hematopoietic stem-cell transplantation for patients 50 years or older with myelodysplastic syndromes or secondary acute myeloid leukemia
.
J Clin Oncol
.
2010
;
28
(
3
):
405
-
411
.
16.
McClune
BL
,
Weisdorf
DJ
,
Pedersen
TL
, et al
.
Effect of age on outcome of reduced-intensity hematopoietic cell transplantation for older patients with acute myeloid leukemia in first complete remission or with myelodysplastic syndrome
.
J Clin Oncol
.
2010
;
28
(
11
):
1878
-
1887
.
17.
Penack
O
,
Peczynski
C
,
Mohty
M
, et al
.
How much has allogeneic stem cell transplant-related mortality improved since the 1980s? A retrospective analysis from the EBMT
.
Blood Adv
.
2020
;
4
(
24
):
6283
-
6290
.
18.
Arber
DA
,
Orazi
A
,
Hasserjian
RP
, et al
.
International Consensus classification of myeloid neoplasms and acute leukemias: integrating morphologic, clinical, and genomic data
.
Blood
.
2022
;
140
(
11
):
1200
-
1228
.
19.
Khoury
JD
,
Solary
E
,
Abla
O
, et al
.
The 5th edition of the World Health organization classification of haematolymphoid tumours: myeloid and histiocytic/dendritic neoplasms
.
Leukemia
.
2022
;
36
(
7
):
1703
-
1719
.
20.
Della Porta
MG
,
Jackson
CH
,
Alessandrino
EP
, et al
.
Decision analysis of allogeneic hematopoietic stem cell transplantation for patients with myelodysplastic syndrome stratified according to the revised International Prognostic Scoring System
.
Leukemia
.
2017
;
31
(
11
):
2449
-
2457
.
21.
Koreth
J
,
Pidala
J
,
Perez
WS
, et al
.
Role of reduced-intensity conditioning allogeneic hematopoietic stem-cell transplantation in older patients with de novo myelodysplastic syndromes: an international collaborative decision analysis
.
J Clin Oncol
.
2013
;
31
(
21
):
2662
-
2670
.
22.
Yoshizato
T
,
Nannya
Y
,
Atsuta
Y
, et al
.
Genetic abnormalities in myelodysplasia and secondary acute myeloid leukemia: impact on outcome of stem cell transplantation
.
Blood
.
2017
;
129
(
17
):
2347
-
2358
.
23.
Della Porta
MG
,
Gallì
A
,
Bacigalupo
A
, et al
.
Clinical effects of driver somatic mutations on the outcomes of patients with myelodysplastic syndromes treated with allogeneic hematopoietic stem-cell transplantation
.
J Clin Oncol
.
2016
;
34
(
30
):
3627
-
3637
.
24.
Bejar
R
,
Stevenson
KE
,
Caughey
B
, et al
.
Somatic mutations predict poor outcome in patients with myelodysplastic syndrome after hematopoietic stem-cell transplantation
.
J Clin Oncol
.
2014
;
32
(
25
):
2691
-
2698
.
25.
Ciurea
SO
,
Chilkulwar
A
,
Saliba
RM
, et al
.
Prognostic factors influencing survival after allogeneic transplantation for AML/MDS patients with TP53 mutations
.
Blood
.
2018
;
131
(
26
):
2989
-
2992
.
26.
Gurnari
C
,
Robin
M
,
Godley
LA
, et al
.
Germline predisposition traits in allogeneic hematopoietic stem-cell transplantation for myelodysplastic syndromes: a survey-based study and position paper on behalf of the Chronic Malignancies Working Party of the EBMT
.
Lancet Haematol
.
2023
;
10
(
12
):
e994
-
1005
.
27.
de Witte
T
,
Bowen
D
,
Robin
M
, et al
.
Allogeneic hematopoietic stem cell transplantation for MDS and CMML: recommendations from an international expert panel
.
Blood
.
2017
;
129
(
13
):
1753
-
1762
.
28.
National Comprehensive Cancer Network. MDS (Version 1.2023)
. Accessed 29 December 2023. https://www.nccn.org/professionals/physician_gls/pdf/mds.pdf.
29.
Pease
DF
,
Ross
JA
,
Poynter
JN
, et al
.
Differences in community and academic practice patterns for newly diagnosed myelodysplastic syndromes (MDS) patients
.
Cancer Epidemiol
.
2015
;
39
(
2
):
222
-
228
.
30.
Muffly
LS
,
Kocherginsky
M
,
Stock
W
, et al
.
Geriatric assessment to predict survival in older allogeneic hematopoietic cell transplantation recipients
.
Haematologica
.
2014
;
99
(
8
):
1373
-
1379
.
31.
Polverelli
N
,
Tura
P
,
Battipaglia
G
, et al
.
Multidimensional geriatric assessment for elderly hematological patients (≥60 years) submitted to allogeneic stem cell transplantation. A French–Italian 10-year experience on 228 patients
.
Bone Marrow Transplant
.
2020
;
55
(
12
):
2224
-
2233
.
32.
Malagola
M
,
Polverelli
N
,
Rubini
V
, et al
.
GITMO registry study on allogeneic transplantation in patients aged ≥60 years from 2000 to 2017: improvements and criticisms
.
Transplant Cell Ther
.
2022
;
28
(
2
):
96.e1
-
96.e11
.
33.
Della Porta
MG
,
Alessandrino
EP
,
Bacigalupo
A
, et al
.
Predictive factors for the outcome of allogeneic transplantation in patients with MDS stratified according to the revised IPSS-R
.
Blood
.
2014
;
123
(
15
):
2333
-
2342
.
34.
Shaffer
BC
,
Ahn
KW
,
Hu
ZH
, et al
.
Scoring system prognostic of outcome in patients undergoing allogeneic hematopoietic cell transplantation for myelodysplastic syndrome
.
J Clin Oncol
.
2016
;
34
(
16
):
1864
-
1871
.
35.
Gagelmann
N
,
Eikema
DJ
,
Stelljes
M
, et al
.
Optimized EBMT transplant-specific risk score in myelodysplastic syndromes after allogeneic stem-cell transplantation
.
Haematologica
.
2019
;
104
(
5
):
929
-
936
.
36.
Platzbecker
U
.
Treatment of MDS
.
Blood
.
2019
;
133
(
10
):
1096
-
1107
.
37.
Robin
M
,
Porcher
R
,
Adès
L
, et al
.
HLA-matched allogeneic stem cell transplantation improves outcome of higher risk myelodysplastic syndrome A prospective study on behalf of SFGM-TC and GFM
.
Leukemia
.
2015
;
29
(
7
):
1496
-
1501
.
38.
Nakai
K
,
Kanda
Y
,
Fukuhara
S
, et al
.
Value of chemotherapy before allogeneic hematopoietic stem cell transplantation from an HLA-identical sibling donor for myelodysplastic syndrome
.
Leukemia
.
2005
;
19
(
3
):
396
-
401
.
39.
Alessandrino
EP
,
Della Porta
MG
,
Bacigalupo
A
, et al
.
WHO classification and WPSS predict posttransplantation outcome in patients with myelodysplastic syndrome: a study from the Gruppo Italiano Trapianto di Midollo Osseo (GITMO)
.
Blood
.
2008
;
112
(
3
):
895
-
902
.
40.
Garcia
JS
,
Platzbecker
U
,
Odenike
O
, et al
.
Efficacy and safety of venetoclax in combination with azacitidine for the treatment of patients with treatment-naive, higher-risk myelodysplastic syndromes
.
Blood
.
2023
;
142
(
suppl 1
):
319-319
.
41.
Damaj
G
,
Duhamel
A
,
Robin
M
, et al
.
Impact of azacitidine before allogeneic stem-cell transplantation for myelodysplastic syndromes: a study by the Société Française de Greffe de Moelle et de Thérapie-Cellulaire and the Groupe-Francophone des Myélodysplasies
.
J Clin Oncol
.
2012
;
30
(
36
):
4533
-
4540
.
42.
Gerds
AT
,
Gooley
TA
,
Estey
EH
,
Appelbaum
FR
,
Deeg
HJ
,
Scott
BL
.
Pretransplantation therapy with azacitidine vs induction chemotherapy and posttransplantation outcome in patients with MDS
.
Biol Blood Marrow Transplant
.
2012
;
18
(
8
):
1211
-
1218
.
43.
Lin
RJ
,
Artz
AS
.
Allogeneic hematopoietic cell transplantation for older patients
.
Hematology
.
2021
;
2021
(
1
):
254
-
263
.
44.
Heuser
M
,
Freeman
SD
,
Ossenkoppele
GJ
, et al
.
2021 Update on MRD in acute myeloid leukemia: a consensus document from the European LeukemiaNet MRD Working Party
.
Blood
.
2021
;
138
(
26
):
2753
-
2767
.
45.
Zeidan
AM
,
Platzbecker
U
,
Bewersdorf
JP
, et al
.
Consensus proposal for revised International Working Group response criteria for higher risk myelodysplastic syndromes
.
Blood
.
2023
;
141
(
17
):
2047
-
2061
.
46.
Robinson
TM
,
Bowman
RL
,
Persaud
S
, et al
.
Single-cell genotypic and phenotypic analysis of measurable residual disease in acute myeloid leukemia
.
Sci Adv
.
2023
;
9
(
38
):
eadg0488
.
47.
Nakamura
S
,
Yokoyama
K
,
Shimizu
E
, et al
.
Prognostic impact of circulating tumor DNA status post–allogeneic hematopoietic stem cell transplantation in AML and MDS
.
Blood
.
2019
;
133
(
25
):
2682
-
2695
.
48.
Lindsley
RC
,
Saber
W
,
Mar
BG
, et al
.
Prognostic mutations in myelodysplastic syndrome after stem-cell transplantation
.
N Engl J Med
.
2017
;
376
(
6
):
536
-
547
.
49.
Ma
Y
,
Wei
Z
,
Xu
Y
, et al
.
Poor pretransplantation minimal residual disease clearance as an independent prognostic risk factor for survival in myelodysplastic syndrome with excess blasts: a multicenter, retrospective cohort study
.
Cancer
.
2023
;
129
(
13
):
2013
-
2022
.
50.
Festuccia
M
,
Deeg
HJ
,
Gooley
TA
, et al
.
Minimal identifiable disease and the role of conditioning intensity in hematopoietic cell transplantation for myelodysplastic syndrome and acute myelogenous leukemia evolving from myelodysplastic syndrome
.
Biol Blood Marrow Transplant
.
2016
;
22
(
7
):
1227
-
1233
.
51.
Dillon
LW
,
Gui
G
,
Logan
BR
, et al
.
Impact of conditioning intensity and genomics on relapse after allogeneic transplantation for patients with myelodysplastic syndrome
.
JCO Precis Oncol
.
2021
;
5
:
265
-
274
.
52.
SCHULZ
E
,
Aplan
PD
,
Freeman
SD
,
Pavletic
SZ
.
Towards a conceptualization of measurable residual disease in myelodysplastic syndromes
.
Blood Adv
.
2023
;
7
(
16
):
4381
-
4394
.
53.
Malagola
M
,
Polverelli
N
,
Beghin
A
, et al
.
Bone marrow CD34+ molecular chimerism as an early predictor of relapse after allogeneic stem cell transplantation in patients with acute myeloid leukemia
.
Front Oncol
.
2023
;
13
:
1133418
.
54.
Scott
BL
,
Pasquini
MC
,
Fei
M
, et al
.
Myeloablative versus reduced-intensity conditioning for hematopoietic cell transplantation in acute myelogenous leukemia and myelodysplastic syndromes-long-term follow-up of the BMT CTN 0901 clinical trial
.
Transplant Cell Ther
.
2021
;
27
(
6
):
483.e1
-
483.e6
.
55.
Kröger
N
,
Iacobelli
S
,
Franke
GN
, et al
.
Dose-reduced versus standard conditioning followed by allogeneic stem-cell transplantation for patients with myelodysplastic syndrome: a prospective randomized phase III study of the EBMT (RICMAC Trial)
.
J Clin Oncol
.
2017
;
35
(
19
):
2157
-
2164
.
56.
Oran
B
,
Woo Ahn
K
,
Fretham
C
, et al
.
Fludarabine and melphalan compared with reduced doses of busulfan and flurabine improves transplant outcomes in older MDS patients
.
Blood
.
2019
;
134
(
suppl 1
):
253-253
.
57.
Spyridonidis
A
,
Labopin
M
,
Savani
BN
, et al
.
Redefining and measuring transplant conditioning intensity in current era: a study in acute myeloid leukemia patients
.
Bone Marrow Transplant
.
2020
;
55
(
6
):
1114
-
1125
.
58.
Luznik
L
,
O’Donnell
PV
,
Symons
HJ
, et al
.
HLA-haploidentical bone marrow transplantation for hematologic malignancies using nonmyeloablative conditioning and high-dose, posttransplantation cyclophosphamide
.
Biol Blood Marrow Transplant
.
2008
;
14
(
6
):
641
-
650
.
59.
Besse
K
,
Maiers
M
,
Confer
D
,
Albrecht
M
.
On modeling human leukocyte antigen–identical sibling match probability for allogeneic hematopoietic cell transplantation: estimating the need for an unrelated donor source
.
Biol Blood Marrow Transplant
.
2016
;
22
(
3
):
410
-
417
.
60.
Guru Murthy
GS
,
Kim
S
,
Hu
ZH
, et al
.
Relapse and disease-free survival in patients with myelodysplastic syndrome undergoing allogeneic hematopoietic cell transplantation using older matched sibling donors vs younger matched unrelated donors
.
JAMA Oncol
.
2022
;
8
(
3
):
404
-
411
.
61.
Kröger
N
,
Zabelina
T
,
de Wreede
L
, et al
.
Allogeneic stem cell transplantation for older advanced MDS patients: improved survival with young unrelated donor in comparison with HLA-identical siblings
.
Leukemia
.
2013
;
27
(
3
):
604
-
609
.
62.
Barker
JN
,
Boughan
K
,
Dahi
PB
, et al
.
Racial disparities in access to HLA-matched unrelated donor transplants: a prospective 1312-patient analysis
.
Blood Adv
.
2019
;
3
(
7
):
939
-
944
.
63.
Saber
W
,
Cutler
CS
,
Nakamura
R
, et al
.
Impact of donor source on hematopoietic cell transplantation outcomes for patients with myelodysplastic syndromes (MDS)
.
Blood
.
2013
;
122
(
11
):
1974
-
1982
.
64.
Maurer
K
,
Ho
VT
,
Inyang
E
, et al
.
Posttransplant cyclophosphamide vs tacrolimus–based GVHD prophylaxis: lower incidence of relapse and chronic GVHD
.
Blood Adv
.
2023
;
7
(
15
):
3903
-
3915
.
65.
Grunwald
MR
,
Zhang
MJ
,
Elmariah
H
, et al
.
Alternative donor transplantation for myelodysplastic syndromes: haploidentical relative and matched unrelated donors
.
Blood Adv
.
2021
;
5
(
4
):
975
-
983
.
66.
Robin
M
,
Porcher
R
,
Ruggeri
A
, et al
.
HLA-mismatched donors in patients with myelodysplastic syndrome: an EBMT registry analysis
.
Biol Blood Marrow Transplant
.
2019
;
25
(
1
):
114
-
120
.
67.
Piemontese
S
,
Boumendil
A
,
Labopin
M
, et al
.
Leukemia relapse following unmanipulated haploidentical transplantation: a risk factor analysis on behalf of the ALWP of the EBMT
.
J Hematol Oncol
.
2019
;
12
(
1
):
68
.
68.
DeFilipp
Z
,
Ciurea
SO
,
Cutler
C
, et al
.
Hematopoietic cell transplantation in the management of myelodysplastic syndrome: an evidence-based review from the American Society for Transplantation and Cellular Therapy Committee on Practice Guidelines
.
Transplant Cell Ther
.
2023
;
29
(
2
):
71
-
81
.
69.
Gerds
AT
,
Woo Ahn
K
,
Hu
ZH
, et al
.
Outcomes after umbilical cord blood transplantation for myelodysplastic syndromes
.
Biol Blood Marrow Transplant
.
2017
;
23
(
6
):
971
-
979
.
70.
Kekre
N
,
Kim
HT
,
Thanarajasingam
G
, et al
.
Efficacy of immune suppression tapering in treating relapse after reduced intensity allogeneic stem cell transplantation
.
Haematologica
.
2015
;
100
(
9
):
1222
-
1227
.
71.
Oran
B
,
Giralt
S
,
Couriel
D
, et al
.
Treatment of AML and MDS relapsing after reduced-intensity conditioning and allogeneic hematopoietic stem cell transplantation
.
Leukemia
.
2007
;
21
(
12
):
2540
-
2544
.
72.
Kolb
HJ
,
Mittermüller
J
,
Clemm
C
, et al
.
Donor leukocyte transfusions for treatment of recurrent chronic myelogenous leukemia in marrow transplant patients
.
Blood
.
1990
;
76
(
12
):
2462
-
2465
.
73.
Motabi
IH
,
Ghobadi
A
,
Liu
J
, et al
.
Chemotherapy versus hypomethylating agents for the treatment of relapsed acute myeloid leukemia and myelodysplastic syndrome after allogeneic stem cell transplant
.
Biol Blood Marrow Transplant
.
2016
;
22
(
7
):
1324
-
1329
.
74.
Bachireddy
P
,
Hainz
U
,
Rooney
M
, et al
.
Reversal of in situ T-cell exhaustion during effective human antileukemia responses to donor lymphocyte infusion
.
Blood
.
2014
;
123
(
9
):
1412
-
1421
.
75.
Deol
A
,
Lum
LG
.
Role of donor lymphocyte infusions in relapsed hematological malignancies after stem cell transplantation revisited
.
Cancer Treat Rev
.
2010
;
36
(
7
):
528
-
538
.
76.
Orti
G
,
Barba
P
,
Fox
L
,
Salamero
O
,
Bosch
F
,
Valcarcel
D
.
Donor lymphocyte infusions in AML and MDS: Enhancing the graft-versus-leukemia effect
.
Exp Hematol
.
2017
;
48
:
1
-
11
.
77.
Yan
CH
,
Liu
DH
,
Liu
KY
, et al
.
Risk stratification–directed donor lymphocyte infusion could reduce relapse of standard-risk acute leukemia patients after allogeneic hematopoietic stem cell transplantation
.
Blood
.
2012
;
119
(
14
):
3256
-
3262
.
78.
Krishnamurthy
P
,
Potter
VT
,
Barber
LD
, et al
.
Outcome of donor lymphocyte infusion after T cell–depleted allogeneic hematopoietic stem cell transplantation for acute myelogenous leukemia and myelodysplastic syndromes
.
Biol Blood Marrow Transplant
.
2013
;
19
(
4
):
562
-
568
.
79.
Deol
A
,
Lum
LG
.
Role of donor lymphocyte infusions in relapsed hematological malignancies after stem cell transplantation revisited
.
Cancer Treat Rev
.
2010
;
36
(
7
):
528
-
538
.
80.
Collins
RH
,
Shpilberg
O
,
Drobyski
WR
, et al
.
Donor leukocyte infusions in 140 patients with relapsed malignancy after allogeneic bone marrow transplantation
.
J Clin Oncol
.
1997
;
15
(
2
):
433
-
444
.
81.
Middeke
JM
,
Herbst
R
,
Parmentier
S
, et al
.
Clofarabine salvage therapy before allogeneic hematopoietic stem cell transplantation in patients with relapsed or refractory AML: results of the BRIDGE trial
.
Leukemia
.
2016
;
30
(
2
):
261
-
267
.
82.
Zuanelli Brambilla
C
,
Lobaugh
SM
,
Ruiz
JD
, et al
.
Relapse after allogeneic stem cell transplantation of acute myelogenous leukemia and myelodysplastic syndrome and the importance of second cellular therapy
.
Transplant Cell Ther
.
2021
;
27
(
9
):
771.e1
-
771.e10
.
83.
Shimomura
Y
,
Hara
M
,
Tachibana
T
, et al
.
Outcomes of second allogeneic haematopoietic stem cell transplantation in patients with relapse of myelodysplastic syndrome
.
Br J Haematol
.
2019
;
186
(
1
):
86
-
90
.
84.
Schmid
C
,
de Wreede
LC
,
van Biezen
A
, et al
.
Outcome after relapse of myelodysplastic syndrome and secondary acute myeloid leukemia following allogeneic stem cell transplantation: a retrospective registry analysis on 698 patients by the Chronic Malignancies Working Party of the European Society of Blood and Marrow Transplantation
.
Haematologica
.
2018
;
103
(
2
):
237
-
245
.
85.
Kernan
NA
,
Grupp
S
,
Smith
AR
, et al
.
Final results from a defibrotide treatment-IND study for patients with hepatic veno-occlusive disease/sinusoidal obstruction syndrome
.
Br J Haematol
.
2018
;
181
(
6
):
816
-
827
.
86.
Coppell
JA
,
Richardson
PG
,
Soiffer
R
, et al
.
Hepatic veno-occlusive disease following stem cell transplantation: incidence, clinical course, and outcome
.
Biol Blood Marrow Transplant
.
2010
;
16
(
2
):
157
-
168
.
87.
Khimani
F
,
McDonald
GB
,
Shulman
HM
, et al
.
Hepatic veno-occlusive disease following sirolimus-based immune suppression
.
Bone Marrow Transplant
.
2019
;
54
(
1
):
85
-
89
.
88.
Corbacioglu
S
,
Jabbour
EJ
,
Mohty
M
.
Risk factors for development of and progression of hepatic veno-occlusive disease/sinusoidal obstruction syndrome
.
Biol Blood Marrow Transplant
.
2019
;
25
(
7
):
1271
-
1280
.
89.
Carreras
E
,
Bertz
H
,
Arcese
W
, et al
.
Incidence and outcome of hepatic veno-occlusive disease after blood or marrow transplantation: a prospective cohort study of the European Group for Blood and Marrow Transplantation. European Group for Blood and Marrow Transplantation Chronic Leukemia Working Party
.
Blood
.
1998
;
92
(
10
):
3599
-
3604
.
90.
Carreras
E
,
Díaz-Beyá
M
,
Rosiñol
L
,
Martínez
C
,
Fernández-Avilés
F
,
Rovira
M
.
The incidence of veno-occlusive disease following allogeneic hematopoietic stem cell transplantation has diminished and the outcome improved over the last decade
.
Biol Blood Marrow Transplant
.
2011
;
17
(
11
):
1713
-
1720
.
91.
Imus
PH
,
Blackford
AL
,
Bettinotti
M
, et al
.
Major histocompatibility mismatch and donor choice for second allogeneic bone marrow transplantation
.
Biol Blood Marrow Transplant
.
2017
;
23
(
11
):
1887
-
1894
.
92.
Christopeit
M
,
Kuss
O
,
Finke
J
, et al
.
Second allograft for hematologic relapse of acute leukemia after first allogeneic stem-cell transplantation from related and unrelated donors: the role of donor change
.
J Clin Oncol
.
2013
;
31
(
26
):
3259
-
3271
.
93.
Dinardo
C
,
Roboz
G
,
M Watts
J
, et al
.
P724: updated substudy results for ivosidenib in IDH1-mutant relapsed/refractory myelodysplastic syndrome
.
Hemasphere
.
2023
;
7
(
S3
):
e75740ab
.
94.
Stein
EM
,
DiNardo
CD
,
Fathi
AT
, et al
.
Molecular remission and response patterns in patients with mutant-IDH2 acute myeloid leukemia treated with enasidenib
.
Blood
.
2019
;
133
(
7
):
676
-
687
.
95.
Ades
L
,
Dimicoli-Salazar
S
,
Sebert
M
, et al
.
Enasidenib (ENA) is effective in patients with IDH2 mutated myelodysplastic syndrome (MDS): the Ideal phase 2 study by the GFM Group
.
Blood
.
2021
;
138
(
suppl 1
):
63
.
96.
Venugopal
S
,
Dinardo
CD
,
Takahashi
K
, et al
.
Phase II study of the IDH2-inhibitor enasidenib in patients with high-risk IDH2-mutated myelodysplastic syndromes (MDS)
.
J Clin Oncol
.
2021
;
39
(
suppl 15
):
7010
.
97.
Sebert
M
,
Cluzeau
T
,
Beyne Rauzy
O
, et al
.
Ivosidenib monotherapy is effective in patients with IDH1 mutated myelodysplastic syndrome (MDS): the Idiome phase 2 study by the GFM Group
.
Blood
.
2021
;
138
(
suppl 1
):
62
.
98.
Bains
A
,
Luthra
R
,
Medeiros
LJ
,
Zuo
Z
.
FLT3 and NPM1 mutations in myelodysplastic syndromes
.
Am J Clin Pathol
.
2011
;
135
(
1
):
62
-
69
.
99.
Richard-Carpentier
G
,
DeZern
AE
,
Takahashi
K
, et al
.
Preliminary results from the phase II study of the IDH2-inhibitor enasidenib in patients with high-risk IDH2-mutated myelodysplastic syndromes (MDS)
.
Blood
.
2019
;
134
(
suppl 1
):
678-678
.
100.
Ades
L
,
Dimicoli-Salazar
S
,
Sebert
M
, et al
.
Enasidenib (ENA) is effective in patients with IDH2 mutated myelodysplastic syndrome (MDS) : the ideal phase 2 study by the GFM group
.
Blood
.
2021
;
138
(
suppl 1
):
63
. 63.
101.
Pang
WW
,
Czechowicz
A
,
Logan
AC
, et al
.
Anti-CD117 antibody depletes normal and myelodysplastic syndrome human hematopoietic stem cells in xenografted mice
.
Blood
.
2019
;
133
(
19
):
2069
-
2078
.
102.
Luznik
L
,
Bolaños-Meade
J
,
Zahurak
M
, et al
.
High-dose cyclophosphamide as single-agent, short-course prophylaxis of graft-versus-host disease
.
Blood
.
2010
;
115
(
16
):
3224
-
3230
.
103.
Mielcarek
M
,
Furlong
T
,
O’Donnell
P V
, et al
.
Posttransplantation cyclophosphamide for prevention of graft-versus-host disease after HLA-matched mobilized blood cell transplantation
.
Blood
.
2016
;
127
(
11
):
1502
-
1508
.
104.
Al Malki
MM
,
Tsai
NC
,
Palmer
J
, et al
.
Posttransplant cyclophosphamide as GVHD prophylaxis for peripheral blood stem cell HLA-mismatched unrelated donor transplant
.
Blood Adv
.
2021
;
5
(
12
):
2650
-
2659
.
105.
Valcárcel
D
,
Martino
R
,
Caballero
D
, et al
.
Sustained remissions of high-risk acute myeloid leukemia and myelodysplastic syndrome after reduced-intensity conditioning allogeneic hematopoietic transplantation: chronic graft-versus-host disease is the strongest factor improving survival
.
J Clin Oncol
.
2008
;
26
(
4
):
577
-
584
.
106.
Bolaños-Meade
J
,
Hamadani
M
,
Wu
J
, et al
.
Post-transplantation cyclophosphamide-based graft-versus-host disease prophylaxis
.
N Engl J Med
.
2023
;
388
(
25
):
2338
-
2348
.
107.
Chang
YJ
,
Wu
DP
,
Lai
YR
, et al
.
Antithymocyte globulin for matched sibling donor transplantation in patients with hematologic malignancies: a multicenter, open-label, randomized controlled study
.
J Clin Oncol
.
2020
;
38
(
29
):
3367
-
3376
.
108.
Yang
X
,
Li
D
,
Xie
Y
.
Anti-thymocyte globulin prophylaxis in patients with hematological malignancies undergoing allogeneic hematopoietic stem cell transplantation: an updated meta-analysis
.
Front Oncol
.
2021
;
11
:
11
.
109.
Dulery
R
,
Malard
F
,
Brissot
E
, et al
.
Reduced post-transplant cyclophosphamide dose associated with antithymocyte globulin in peripheral blood stem cell haploidentical transplantation
.
Blood
.
2022
;
140
(
suppl 1
):
10517
-
10518
.
110.
DeFilipp
Z
,
Chen
YB
.
How I treat with maintenance therapy after allogeneic HCT
.
Blood
.
2023
;
141
(
1
):
39
-
48
.
111.
Dholaria
B
,
Savani
BN
,
Hamilton
BK
, et al
.
Hematopoietic cell transplantation in the treatment of newly diagnosed adult acute myeloid leukemia: an evidence-based review from the American Society of Transplantation and Cellular Therapy
.
Transplant Cell Ther
.
2021
;
27
(
1
):
6
-
20
.
112.
Oran
B
,
de Lima
M
,
Garcia-Manero
G
, et al
.
A phase 3 randomized study of 5-azacitidine maintenance vs observation after transplant in high-risk AML and MDS patients
.
Blood Adv
.
2020
;
4
(
21
):
5580
-
5588
.
113.
de Lima
M
,
Oran
B
,
Champlin
RE
, et al
.
CC-486 maintenance after stem cell transplantation in patients with acute myeloid leukemia or myelodysplastic syndromes
.
Biol Blood Marrow Transplant
.
2018
;
24
(
10
):
2017
-
2024
.
114.
Stevens
BM
,
Zhang
W
,
Pollyea
DA
, et al
.
CD123 CAR T cells for the treatment of myelodysplastic syndrome
.
Exp Hematol
.
2019
;
74
:
52
-
63.e3
.
115.
Chapuis
AG
,
Egan
DN
,
Bar
M
, et al
.
T cell receptor gene therapy targeting WT1 prevents acute myeloid leukemia relapse post-transplant
.
Nat Med
.
2019
;
25
(
7
):
1064
-
1072
.
116.
Huang
XJ
,
Liu
DH
,
Liu
KY
, et al
.
Modified donor lymphocyte infusion after HLA-mismatched/haploidentical T cell-replete hematopoietic stem cell transplantation for prophylaxis of relapse of leukemia in patients with advanced leukemia
.
J Clin Immunol
.
2008
;
28
(
3
):
276
-
283
.
117.
Gao
XN
,
Lin
J
,
Wang
SH
, et al
.
Donor lymphocyte infusion for prevention of relapse after unmanipulated haploidentical PBSCT for very high-risk hematologic malignancies
.
Ann Hematol
.
2019
;
98
(
1
):
185
-
193
.
118.
Von Dem Borne
PA
,
Snijders
TJF
,
van Lammeren
D
, et al
.
Prophylactic donor lymphocyte infusion in patients after allogeneic stem cell transplantation with post-transplant cyclophosphamide is associated with low relapse risk and excellent survival in patients below 65 years with acute myeloid leukemia and high-risk myelodysplasia
.
Blood
.
2022
;
140
(
suppl 1
):
7742
-
7743
.
119.
Estey
E
,
Hasserjian
RP
,
Döhner
H
.
Distinguishing AML from MDS: a fixed blast percentage may no longer be optimal
.
Blood
.
2022
;
139
(
3
):
323
-
332
.
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