Allogeneic HCT Feasible in Older Patients With Myelodysplastic Syndrome

WEDNESDAY, July 23, 2025 (HealthDay News) — Allogeneic hematopoietic cell transplantation (allo-HCT) is feasible in older patients with myelodysplastic syndrome (MDS), according to a study published online June 26 in the European Journal of Haematology.

Fernando Barroso Duarte, Ph.D., from Walter Cantídio University Hospital in Fortaleza, Brazil, and colleagues conducted a retrospective multicenter study to compare outcomes and assess risks associated with allo-HCT in patients with MDS aged 65 years and older versus younger than 65 years across 38 transplant centers in Latin America from 1988 to 2023. A total of 441 patients were enrolled; 16 percent were aged 65 years and older.

The researchers found that overall survival (OS) was 49.3 and 56.7 percent in patients 65 years and older and those younger than 65 years, respectively, at five years, and progression-free survival (PFS) was 48.4 and 56.2 percent, respectively. The cumulative incidence rates of relapse and nonrelapse mortality were 13.6 and 33.8 percent, respectively. No significant differences were seen between the age groups in OS, nonrelapse mortality, or PFS after propensity score matching. There was an association seen between PFS in patients aged 65 years and older with high-risk Revised International Prognostic Scoring System stratification. A higher risk for relapse was seen for patients aged 65 years and older compared with those aged younger than 65 years. Prevalence risk was associated with male sex, reduced-intensity conditioning, mobilized blood cells, and prior treatment in patients aged 65 years and older, while in those aged younger than 65 years, associations were seen with complications and chronic graft-versus-host disease.

“Allo-HCT is feasible in elderly patients with MDS, with no significant differences in OS or mortality risk compared to younger patients,” the authors write. “However, age may influence disease progression in very high-risk elderly patients with MDS, as well as the risk of relapse after transplantation. We identified that male sex, the use of a reduced-intensity conditioning regimen, and a mobilized blood cell graft are prevalent risk factors associated with elderly patients with MDS undergoing HCT.”

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