Factors associated with hematopoietic cell transplantation (HCT) among patients in a population-based study of myelodysplastic syndrome (MDS) in Minnesota.
Factors associated with hematopoietic cell transplantation (HCT) among patients in a population-based study of myelodysplastic syndrome (MDS) in Minnesota.
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DOI：
10.1007/s00277-015-2422-z
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发表时间：
2015-10
影响因子：
3.5
通讯作者：
Ross JA
中科院分区：
文献类型：
--
作者：
Smith AR;Warlick ED;Roesler MA;Poynter JN;Richardson M;Nguyen P;Cioc A;Hirsch B;Ross JA
Myelodysplastic syndrome (MDS) is a clonal hematopoietic stem cell disorder characterized by dysplastic changes in the bone marrow, ineffective erythropoiesis and an increased risk of developing acute myeloid leukemia. Treatment planning for patients with MDS is a complex process and we sought to better characterize HCT outcomes and the factors that play into decision-making regarding referral of adults with MDS for definitive therapy with hematopoietic cell transplantation (HCT). Patients enrolled in a population based study of MDS between April 2010 and January 2013 who underwent HCT within the first year after enrollment were included in this analysis. Age and risk matched MDS patient controls also enrolled during that time period were used as a comparison. Survival was significantly better in the HCT group (48% vs. 21%, log-rank p-value 0.009). Non-HCT patients were more likely to have comorbidities and HCT patients were more likely to have a college degree and an income >$80,000. All three of these variables were independently associated with HCT, but none impacted survival. Patients with MDS in our study who underwent HCT had better survival than a comparable group of patients who did not undergo HCT. With refined treatment techniques more patients may be able to be considered for this therapy. More work needs to be done to determine why education and income appear to impact the decision to pursue HCT, but these factors may impact referral to an academic center where aggressive therapy like HCT is more likely to be considered.
