ArticleJournal of clinical oncology : official journal of the American Society of Clinical Oncology2024
Clinical and Genomic-Based Decision Support System to Define the Optimal Timing of Allogeneic Hematopoietic Stem-Cell Transplantation in Patients With Myelodysplastic Syndromes.
Article in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
34 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Indications for haematopoietic cell transplantation and CAR-T for haematological diseases, solid tumours and immune disorders: 2025 EBMT practice recommendations.Bone marrow transplantation · 2025Guideline
- Allogeneic hematopoietic cell transplantation for myelodysplastic syndrome in young adults: A retrospective study on behalf of the EBMT Chronic Malignancies Working Party.Bone marrow transplantation · 2026Article
- Dordaviprone Maintenance After Allogeneic HCT for High-Risk Acute Myeloid Leukemia and Myelodysplastic Neoplasm.American journal of hematology · 2026Article
- Indications for Autologous and Allogeneic Hematopoietic Stem-Cell Transplantation in Adults: State of the Art.Journal of clinical medicine · 2026Review
- A 2026 update on myelodysplastic neoplasms: current state, challenges and future directions.Nature reviews. Clinical oncology · 2026Review
- Pre-transplant azacitidine does not improve survival in allogeneic HSCT for higher-risk MDS.Bone marrow transplantation · 2026Article
- Outcomes of patients with higher-risk myelodysplastic syndromes/neoplasms treated with hypomethylating agents + venetoclax-an analysis from the International Consortium for MDS (icMDS) VALIDATE database.Blood cancer journal · 2026Article
- Toolkit for multistate disease progression simulation and treatment decision-making aid.BMC medical research methodology · 2026Article
- Molecular-Based Ecosystem to Improve Personalized Medicine in Chronic Myelomonocytic Leukemia.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2026Article
- Real-world, multi-omics validation of the clinical relevance of molecular taxonomy for myelodysplastic syndromes (MDS).HemaSphere · 2026Article
- Application of next-generation sequencing in the treatment of myelodysplastic syndrome: from mechanisms to clinical practice.Blood science (Baltimore, Md.) · 2026Review
- IPSS-M downstaging before transplantation does not improve the prognosis of patients with myelodysplastic neoplasms.Bone marrow transplantation · 2026Article
- Prognostic value of measurable residual disease in high-risk MDS after intensive chemotherapy in HOVON-SAKK studies.HemaSphere · 2026Article
- Therapy of high-risk myelodysplastic syndromes.Bone marrow transplantation · 2026Review
- Baseline IPSS-M vs pretransplant risk downstaging as prognostic determinants in MDS undergoing allogeneic transplantation.Blood advances · 2026Article
- Autoimmune HLA alleles and neoantigens predict myelodysplastic syndrome outcomes after allogeneic HSCT: A CIBMTR analysis.iScience · 2026Article
- Repeated courses of sequential venetoclax and donor lymphocyte infusions in a patient with relapsed high-risk myelodysplasia following allogeneic stem cell transplantation: a case report.Frontiers in immunology · 2026Article
- Hypomethylating agents are the current therapy backbone for MDS and AML relapsing after allogeneic hematopoietic stem cell transplantation.Frontiers in immunology · 2026Review
- How to Read a Next-Generation Sequencing Report for AML and MDS? What Hematologists Need to Know.Journal of clinical medicine · 2025Review
- Improving MDS Risk Assessment: The Role of Monocytopenia and Lymphocytopenia Beyond IPSS-R.Medicina (Kaunas, Lithuania) · 2025Article
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Authors and funding
41 authors.
Funding
Abstract
purposeAllogeneic hematopoietic stem-cell transplantation (HSCT) is the only potentially curative treatment for patients with myelodysplastic syndromes (MDS). Several issues must be considered when evaluating the benefits and risks of HSCT for patients with MDS, with the timing of transplantation being a crucial question. Here, we aimed to develop and validate a decision support system to define the optimal timing of HSCT for patients with MDS on the basis of clinical and genomic information as provided by the Molecular International Prognostic Scoring System (IPSS-M). PATIENTS AND
methodsWe studied a retrospective population of 7,118 patients, stratified into training and validation cohorts. A decision strategy was built to estimate the average survival over an 8-year time horizon (restricted mean survival time [RMST]) for each combination of clinical and genomic covariates and to determine the optimal transplantation policy by comparing different strategies.
resultsUnder an IPSS-M based policy, patients with either low and moderate-low risk benefited from a delayed transplantation policy, whereas in those belonging to moderately high-, high- and very high-risk categories, immediate transplantation was associated with a prolonged life expectancy (RMST). Modeling decision analysis on IPSS-M versus conventional Revised IPSS (IPSS-R) changed the transplantation policy in a significant proportion of patients (15% of patient candidate to be immediately transplanted under an IPSS-R-based policy would benefit from a delayed strategy by IPSS-M, whereas 19% of candidates to delayed transplantation by IPSS-R would benefit from immediate HSCT by IPSS-M), resulting in a significant gain-in-life expectancy under an IPSS-M-based policy (
conclusionThese results provide evidence for the clinical relevance of including genomic features into the transplantation decision making process, allowing personalizing the hazards and effectiveness of HSCT in patients with MDS.
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