Risk Factors and Indications for Stem Cell Transplants in MDS

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 the current indications for considering stem cell transplants in patients with myelodysplastic syndrome (MDS).

In addition, Giralt delves into how factors like disease risk classification and patient characteristics influence this. Giralt presented on this topic at the 2024 Society of Hematologic Oncology (SOHO) Annual Meeting.

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0:09 | Currently, the current indications for transplant in patients with MDS is in anybody with intermediate- to high-risk disease, or patients in which primary therapy is failing and they are still transfusion-dependent, in which it is felt that transplant will significantly improve their quality and quantity of life.

0:28 | [It is] essential to be able to risk stratify patients, and we now know that some low-risk patients, because of molecular abnormalities, are actually high-risk patients because they will have a higher tendency to transform to acute leukemia. Then, we also know that patients who are scored as intermediate too may actually have lower propensity of progressing.

0:51 | We also have to incorporate the patient specific factors we just heard in this [SOHO] meeting at 8 in the morning, Mohamed L. Sorror, MD, MSc, gave us an excellent presentation of the CHARM [composite health risk assessment model] score, where you could look at patients over the age of 65 and try to prognosticate what the risk of mortality is after transplant. Those types of scoring and risk stratification criteria are really essential for both the patients and the physicians taking care of them, to decide whether the risk benefit ratio of transplant is positive or whether they are a patient is better served by a more conservative approach.