A decision analysis of allogeneic bone marrow transplantation for the myelodysplastic syndromes: delayed transplantation for low-risk myelodysplasia is associated with improved outcome

Bone marrow transplantation (BMT) can cure myelodysplastic syndrome (MDS), although transplantation carries significant risks of morbidity and mortality. Because the optimal timing of HLA-matched BMT for MDS is unknown, we constructed a Markov model to examine 3 transplantation strategies for newly diagnosed MDS: transplantation at diagnosis, transplantation at leukemic progression, and transplantation at an interval from diagnosis but prior to leukemic progression. Analyses using individual patient risk-assessment data from transplantation and nontransplantation registries were performed for all 4 International Prognostic Scoring System (IPSS) risk groups with adjustments for quality of life (QoL). For low…

• LA
  Lynde and Harry Bradley Foundation
• A
  Amgen
• BS
  Bristol-Myers Squibb
• LR
  Leukemia Research Foundation
• BC
  Blue Cross and Blue Shield Association
• MC
  Medical College of Wisconsin
• NC
  National Cancer Institute

  Awards: 24-CA76518, U24-CA76518
• NI
  National Institute of Allergy and Infectious Diseases

  Award: U24-CA76518