Blood transfusions and medications called “hypomethylating drugs,” such as azacitidine and 5-deoxy azacitidine, are standard therapy for myelodysplastic syndromes (MDS) in older patients. While this treatment can improve blood cell counts and extend life, it is not curative. The administration of stem cells from a matched donor, known as an allogeneic transplant, can cure MDS, but it is associated with a high risk of complications in older patients.
With a conventional allogeneic stem cell transplant, patients receive high doses of chemotherapy and radiation therapy to destroy their blood cells and prepare them for the transplant. In this study, researchers are comparing a “reduced-intensity” approach to allogeneic transplantation which uses lower doses of chemotherapy and radiation therapy. It is sometimes called a “mini-transplant,” and may make allogeneic transplantation possible for some older patients with MDS. It is being assessed in this study in patients with MDS age 50 and older.
Patients in this study who have a matched stem cell donor will undergo reduced-intensity allogeneic transplantation. Patients who do not have a match donor will receive standard MDS therapy. Researchers will compare the two groups to see how well they do and to study their quality of life.