What question did this study set out to answer?

To examine trends in survival outcomes after allogeneic transplantation for myelodysplastic syndromes (MDS) and myelodysplastic/myeloproliferative neoplasms (MDS/MPN).

April 8, 2026

Trends in survival outcomes after allogeneic transplantation for MDS and MDS / MPN in a real‐world experience: A 25‐year nationwide study

Key Points

To examine trends in survival outcomes after allogeneic transplantation for myelodysplastic syndromes (MDS) and myelodysplastic/myeloproliferative neoplasms (MDS/MPN).
Analyzed a nationwide database of 7175 patients who received their first allo-HSCT from 1998 to 2022.
Calculated hazard ratios to assess mortality trends over time in different MDS subtypes.
Evaluated non-relapse mortality and relapse incidence across disease categories.
Overall mortality decreased over time in early and advanced MDS, chronic myelomonocytic leukaemia, and atypical chronic myeloid leukaemia.
Significant reductions in non-relapse mortality were observed, particularly in MDS patients.
No significant change in overall mortality was noted in MDS/MPN-unclassified and therapy-related myeloid neoplasms.

Abstract

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.

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