{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T01:09:16Z","timestamp":1792372156526,"version":"4.4.0"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","issue":"11","license":[{"start":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:00:00Z","timestamp":1756425600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:00:00Z","timestamp":1756425600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Bone Marrow Transplant"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Reduced intensity conditioning (RIC) is usually used for patients with myelodysplastic syndrome (MDS) undergoing allogeneic hematopoietic cell transplantation (allo-HCT), particularly in the elderly or those with comorbidities. The impact of conditioning intensity on patients\u2019 outcome remains controversial with clinicians\u2019 subjective opinion\/ experience remaining a major guide in choosing the intensity. Here, we compare RIC\n                    <jats:italic>versus<\/jats:italic>\n                    MAC in a large EBMT retrospective study in MDS patients aged \u226550 years undergoing allo-HCT between 2014 and 2018. Among the 1393 included patients, 922 (66%) were males, and the median age at transplant was 62.8 (50.0\u201377.9) years. The majority of patients (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009884; 64.3%) had MDS with excess blasts. IPSS-R recorded was very low\/low (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009598, 43%), intermediate (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009352, 25%), and high\/very high (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009443, 32%). Karnofsky index was \u226590 in 916 (69.3%) patients, and HCT-CI\u2009\u2265\u20093 in 292(27.3%) patients. A RIC regimen was used in 1053 (75.5%) patients. Median follow-up was 27.9 months (IQR: 26.4\u201330.6). Both uni- and multi-variable analyses did not show any significant association between conditioning intensity and outcomes. This study highlights a lack of association between RIC\/MAC regimens and outcomes in allo-HCT MDS patients. Our results support the recently published systematic review and meta-analysis, where evidence for using one conditioning regimen over another remains weak.\n                  <\/jats:p>","DOI":"10.1038\/s41409-025-02682-3","type":"journal-article","created":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T16:51:28Z","timestamp":1756486288000},"page":"1487-1495","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Conditioning intensity in myelodysplastic patients aged \u2265 50 years undergoing allogeneic hematopoietic cell transplantation (allo-HCT): a study on behalf of the chronic malignancies working party of the EBMT"],"prefix":"10.1038","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8677-7392","authenticated-orcid":false,"given":"Noureddine","family":"Henoun 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Louise","family":"Byrne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Urpu","family":"Salmenniemi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrice","family":"Ceballos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00e9r\u00f4me","family":"Cornillon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2426-3465","authenticated-orcid":false,"given":"Simona","family":"Sica","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2991-3474","authenticated-orcid":false,"given":"Francesco","family":"Onida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christof","family":"Scheid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6829-5544","authenticated-orcid":false,"given":"Carmelo","family":"Gurnari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4562-6264","authenticated-orcid":false,"given":"Joanna","family":"Drozd-Sokolowska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8258-354X","authenticated-orcid":false,"given":"Kavita","family":"Raj","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1388-9876","authenticated-orcid":false,"given":"Marie","family":"Robin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1224-091X","authenticated-orcid":false,"given":"Donal 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Luspatercept in Patients with Lower-Risk Myelodysplastic Syndromes. N. Engl J Med. 2020;382:140\u201351.","journal-title":"N. Engl J Med"},{"key":"2682_CR2","doi-asserted-by":"publisher","first-page":"872","DOI":"10.1001\/jama.2022.14578","volume":"328","author":"MA Sekeres","year":"2022","unstructured":"Sekeres MA, Taylor J. Diagnosis and Treatment of Myelodysplastic Syndromes: A Review. JAMA. 2022;328:872\u201380.","journal-title":"JAMA"},{"key":"2682_CR3","doi-asserted-by":"crossref","unstructured":"Robin M, de Witte T. Myelodysplastic Syndromes. In: Carreras E, Dufour C, Mohty M, Kroger N, editors. The EBMT Handbook: Hematopoietic Stem Cell Transplantation and Cellular Therapies. 7th ed. Cham (CH) 2019. p. 547-56.","DOI":"10.1007\/978-3-030-02278-5_73"},{"key":"2682_CR4","doi-asserted-by":"publisher","first-page":"417","DOI":"10.1111\/bjh.17817","volume":"195","author":"A Shimoni","year":"2021","unstructured":"Shimoni A, Robin M, Iacobelli S, Beelen D, Mufti GJ, Ciceri F, et al. Allogeneic hematopoietic cell transplantation in patients with myelodysplastic syndrome using treosulfan based compared to other reduced-intensity or myeloablative conditioning regimens. A report of the chronic malignancies working party of the EBMT. Br J Haematol. 2021;195:417\u201328.","journal-title":"Br J Haematol"},{"key":"2682_CR5","doi-asserted-by":"publisher","first-page":"1107","DOI":"10.1038\/bmt.2017.19","volume":"52","author":"R Martino","year":"2017","unstructured":"Martino R, Henseler A, van Lint M, Schaap N, Finke J, Beelen D, et al. Long-term follow-up of a retrospective comparison of reduced-intensity conditioning and conventional high-dose conditioning for allogeneic transplantation from matched related donors in myelodysplastic syndromes. Bone Marrow Transpl. 2017;52:1107\u201312.","journal-title":"Bone Marrow Transpl"},{"key":"2682_CR6","doi-asserted-by":"publisher","first-page":"2157","DOI":"10.1200\/JCO.2016.70.7349","volume":"35","author":"N Kroger","year":"2017","unstructured":"Kroger N, Iacobelli S, Franke GN, Platzbecker U, Uddin R, Hubel K, et al. Dose-Reduced Versus Standard Conditioning Followed by Allogeneic Stem-Cell Transplantation for Patients With Myelodysplastic Syndrome: A Prospective Randomized Phase III Study of the EBMT (RICMAC Trial). J Clin Oncol. 2017;35:2157\u201364.","journal-title":"J Clin Oncol"},{"key":"2682_CR7","doi-asserted-by":"publisher","first-page":"224","DOI":"10.1038\/s41409-023-02111-3","volume":"59","author":"V Potter","year":"2024","unstructured":"Potter V, Gras L, Koster L, Kroger N, Sockel K, Ganser A, et al. Sequential vs myeloablative vs reduced intensity conditioning for patients with myelodysplastic syndromes with an excess of blasts at time of allogeneic haematopoietic cell transplantation: a retrospective study by the chronic malignancies working party of the EBMT. Bone Marrow Transpl. 2024;59:224\u201331.","journal-title":"Bone Marrow Transpl"},{"key":"2682_CR8","first-page":"323.e1","volume":"28","author":"S Kurosawa","year":"2022","unstructured":"Kurosawa S, Shimomura Y, Itonaga H, Najima Y, Kobayashi T, Ozawa Y, et al. Myeloablative Versus Reduced-Intensity Conditioning With Fludarabine\/Busulfan for Myelodysplastic Syndrome: A Propensity Score-Matched Analysis. Transpl Cell Ther. 2022;28:323.e1\u2013e9.","journal-title":"Transpl Cell Ther"},{"key":"2682_CR9","doi-asserted-by":"publisher","first-page":"5223","DOI":"10.7150\/jca.46081","volume":"11","author":"S Ma","year":"2020","unstructured":"Ma S, Shi W, Li Z, Tang L, Wang H, Xia L, et al. Reduced-intensity versus Myeloablative Conditioning Regimens for Younger Adults with Acute Myeloid Leukemia and Myelodysplastic Syndrome: A systematic review and meta-analysis. J Cancer. 2020;11:5223\u201335.","journal-title":"J Cancer"},{"key":"2682_CR10","first-page":"483.e1","volume":"27","author":"BL Scott","year":"2021","unstructured":"Scott BL, Pasquini MC, Fei M, Fraser R, Wu J, Devine SM, et al. Myeloablative versus Reduced-Intensity Conditioning for Hematopoietic Cell Transplantation in Acute Myelogenous Leukemia and Myelodysplastic Syndromes-Long-Term Follow-Up of the BMT CTN 0901 Clinical Trial. Transpl Cell Ther. 2021;27:483.e1\u2013e6.","journal-title":"Transpl Cell Ther"},{"key":"2682_CR11","doi-asserted-by":"publisher","first-page":"472","DOI":"10.1007\/s12288-020-01386-6","volume":"37","author":"SK Sharma","year":"2021","unstructured":"Sharma SK, Choudhary D, Doval D, Khandelwal V, Patel A, Setia R, et al. 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The study was performed in accordance with the Declaration of Helsinki and approved by the Sheba Medical Center Helsinki Committee (SMC-770920). Informed consent was obtained from all subjects.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}}]}}