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December 8, 2025BloodOpen Access

Upfront vs posttherapy allogeneic stem cell transplantation for high-risk myelodysplastic syndrome – a real-world analysis in the era of molecular risk stratification

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Authors

UHUdo HoltickDSDaniel SchütteKKKarl-Anton Kreuzer

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Overview

Real-world analysis shows no survival advantage for pre-treated patients undergoing allogeneic stem cell transplantation.

Key Points

  • This analysis aims to compare survival outcomes between upfront and posttherapy allogeneic stem cell transplantation in high-risk myelodysplastic syndrome.
  • Retrospective analysis of 129 patients undergoing first allogeneic stem cell transplantation (ASCT) for high-risk MDS or borderline AML.
  • Patients categorized as frontline ASCT or pre-treated with chemotherapy/hypomethylating agents before ASCT.
  • Evaluated overall survival and progression-free survival using Kaplan–Meier method and log-rank test.
  • Median overall survival was 123.9 months for frontline vs. 44.4 months for pre-treated patients (p = 0.17).
  • Median progression-free survival was 71.0 months for frontline vs. 27.7 months for pre-treated patients (p = 0.096).
  • Pre-transplant IPSS-M score changes showed no significant association with overall or progression-free survival outcomes.

Cite This Study

Holtick et al. (2025) studied this question.

synapsesocial.com/papers/69362f7f4fa91c937236e52fhttps://doi.org/10.1182/blood-2025-2505
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1IPSS-M downstaging before transplantation does not improve the prognosis of patients with myelodysplastic neoplasms2026 · 1 citations
  2. 2Prognostic impact of pre-transplant IPSS-m risk downstaging in Myelodysplastic Syndromes2025
  3. 3Impact of allogeneic transplant vs hypomethylating agents in high-risk myelodysplastic syndromes: A prisma-guided systematic review2025
  4. 4Impact of pre-allogeneic stem cell transplantation (SCT) disease characteristics, therapy, and response on post-SCT outcomes in higher risk myelodysplastic syndromes2025 · 1 citations
  5. 5Optimizing Timing and Preparation for Allogeneic Hematopoietic Stem Cell Transplantation in Higher-Risk Myelodysplastic Syndromes2025