In this review, the authors discuss the clinical decision-making process involved in cytoreductive treatment before HCT with the objective of reducing the incidence of post-transplant relapse in patients with myelodysplastic syndrome (MDS). They note that higher complete remission rates are obtained with pre-transplant induction chemotherapy than are observed with hypomethylating agents (HMAs), but that HMAs may be more effective in patients with complex karyotypes. The authors propose a decision-making algorithm based on disease characteristics, patient age, and comorbidities.
Yakoub-Agha I, et al. Biol Blood Marrow Transplant