Factors Impacting Success of Transplant in Patients With MDS

Ronald L. Paquette, MD, clinical director, Stem Cell and Bone Marrow Transplant Program at Cedars-Sinai Medical Center and Samuel Oschin Cancer Center, discusses

characteristics of myelodysplastic syndrome and how they may impact a patient’s success in undergoing stem cell transplant.

According to Paquette, each patient has a different profile in terms of the histopathologic, cytologic, and molecular features. Moreover, clinical features like a patient’s fitness for therapy, age, and the number and type of comorbidities all impact a physician’s decision-making.

Choosing to transplant often comes down to identifying which patients with MDS have a high enough risk-level to be selected for transplant.

Transcription:

0:07 | Well, the first thing that is important is patient selection. So, I always tell my patients that no 2 patients are alike because of the histopathological features, the cytogenetic features, the molecular features are often dissimilar between two patients that might otherwise be comparable. And you have clinical features like how fit is the patient, how old is the patient, and what are their comorbidities?

0:37 | And so, patient selection for transplant is very important and identifying the patients for whom the risk of the disease is high enough that a curative option like transplant is appropriate and warranted. And then determining which of that population of patients would be able to be successful with a transplant in terms of tolerating the conditioning regimen and the risks of graft-versus-host disease prophylaxis.

1:08 | So that's it, the selection process is convoluted and oftentimes less than clear cut one but many variables have to be taken into account in order to determine who might be a suitable candidate for transplant.