Do the benefits of a BMT outweigh the risks?

Do the benefits of a bone marrow transplant outweigh the risks?

Yeah, this is a very important question for sure. And I want definitely to tie you based on it.

As I mentioned to you, not all in the MDS patients necessarily benefit from allogeneic transplantation early on in their diagnosis. If they are low risk, then the progression of the disease happens very slowly. And since transplant can be associated with morbidity and mortality, we don't recommend them directly proceeding with transplant if they have lower risk disease.

However, if they have higher risk disease, recent respective observational large study demonstrated that if patients have a donor available and they proceed with allogeneic transplantation up to age 75, there is clear benefit and this benefit is a 20% absolute benefit in overall survival if they receive allogeneic transplantation versus if they don't have a donor, for example, to proceed with transplant.

And therefore, based on these data, patients with higher risk disease and up to age 75, it is standard of care to offer these patients allogeneic transplantation as they have a better chance to survive compared to patients who are not receiving transplant.

I also want to mention that allogeneic transplant for myelodysplastic syndrome is the only available curative therapy. There is no other therapy known to us that can cure myelodysplastic syndrome other than transplantation.

Normally, we perform a bone marrow biopsy one month after the transplant procedure to determine the success of BMT. If the transplant is successful, then the bone marrow should have no evidence of myelodysplastic syndrome and it should show mostly donor cell recovery based on testing we call chimerism.