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Old Tue May 23, 2017, 03:41 PM
DanL DanL is offline
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Join Date: Dec 2010
Location: Denver, CO
Posts: 590
Meri,

For MDS, it is unusual to do chemotherapy to reduce the blasts unless you have converted to AML There is some evidence that anything below about 13% blasts does alright with the normal pre-transplant conditioning, while maintaining a lower relapse rate. Many of the studies that I have read suggest that additional traditional chemotherapy prior to transplant may weaken patients too much and reduce the effectiveness of transplant. The exception being for treatment with vidaza or dacogen prior to transplant.

As for the DLI/second transplant if you relapse, I have not seen any information stating that one is better than the other, but there also has not been a lot of published work comparing the two that I am aware of. I think this may be due to the experience of that institution. The data that I have seen refers specifically to DLI and it being effective up to about 25% of the time.

As with most things related to MDS, the data that patients see is somewhat dated and may not reflect the latest medical practice, nor the experience of any given institution.

For example, I relapsed at 6 months and the treatment was six months of vidaza. The caveat is that my relapse was hardly detectable with no increased blasts and only a small cytogenetic anomaly. I have been treatment free for just over 2 years now. According to my Dr. it is what they do when they catch a relapse early and they have had pretty good success with it so far.

Wishing you the best throughout!
Dan
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MDS RCMD w/grade 2-3 fibrosis. Allo-MUD Feb 26, 2014. Relapsed August 2014. Free and clear of MDS since November 2014 after treatment with Vidaza and Rituxan. Experiencing autoimmune attack on CNS thought to be GVHD, some gut, skin and ocular cGVHD. Neuropathy over 80% of body.
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