Giralt on MDS Transplant Timing and Candidacy

Sergio A. Giralt, MD, professor of medicine at Weill Cornell Medical College, attending physician in the Adult Bone Marrow and Transplant Service at Memorial Sloan Kettering Cancer Center, deputy division head Division of Hematologic Malignancies; Melvin Berlin Family Chair in Multiple Myeloma at Memorial Sloan Kettering Cancer Center, discusses how to determine which patient is a candidate for transplant and the optimal time to perform a transplant in patients with myelodysplastic syndrome (MDS).

Giralt covered this topic and more during a session at the 2024 Society of Hematologic Oncology (SOHO) Annual Meeting where he delved into the role of transplant for patients with MDS.

Transcription:

0:09 | I think transplant candidacy is something that we think should be determined in the transplant center by a transplant physician, and they have teams of people who help him or her make this decision. For older patients, we think comprehensive geriatric assessment should be the standard-of-care, because our geriatricians can provide us enormous insight about what the risk of transplant may be for an individual patient.

0:39 | In general, we take into consideration disease risk characteristics, patient risk characteristics, and it is a conversation. We now know everybody has a donor. With post transplant cyclophosphamide, we can now do mismatched-unrelated donors and mismatch-related donors. In reality, what used to be a procedure that was only limited to people who had HLA identical donors within the family, and the registry is now open to everyone.

1:07 | High-risk [patients with] MDS should probably be transplanted as soon as the diagnosis is made. In patients with intermediate- or low-risk disease, it can be something where you can kind of see what the tempo of the disease is. But once again, when these patients develop high-risk molecular abnormalities, the data would show that the earlier they go to transplant, the better it is.