{"entity":{"id":"paper-bmt-ctn-1102-transplant-older-mds-nakamura-jco-2021","kind":"paper","name":"BMT CTN 1102: biologic assignment trial of reduced-intensity transplant by donor availability in patients aged 50 to 75 with advanced myelodysplastic syndrome","aka":[],"tldr":"Older people with higher-risk myelodysplastic syndrome who had a matched donor and went on to a reduced-intensity stem-cell transplant were much more likely to be alive three years later than those without a donor treated with drugs, which makes transplant part of standard planning for fit patients up to 75.","summary":"Multicentre biologic assignment trial of the Blood and Marrow Transplant Clinical Trials Network: 384 patients aged 50 to 75 with intermediate-2 or high-risk de novo myelodysplastic syndrome enrolled at 34 centres between 2014 and 2018 were assigned to the donor arm (reduced-intensity allogeneic transplant) or the no-donor arm (hypomethylating therapy or best supportive care) according to whether a matched donor was identified within 90 days.\n\nIn the intention-to-treat analysis, adjusted three-year overall survival was 47.9 percent in the donor arm against 26.6 percent in the no-donor arm (absolute difference 21.3 percentage points), and leukaemia-free survival 35.8 against 20.6 percent. The benefit was seen across all subgroups examined.","asOf":"2026-09-22","links":[{"label":"J Clin Oncol 2021","url":"https://doi.org/10.1200/JCO.20.03380"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/34106753/"}],"tags":[],"related":[],"cancers":["mds-higher-risk","mds"],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["bmt-ctn-1102"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["jco"],"dependsOn":[],"notes":[],"journal":"Journal of Clinical Oncology","year":2021,"doi":"10.1200/JCO.20.03380","pmid":"34106753","authors":"Nakamura R, Saber W, Martens MJ, et al.","paperType":"rct","findings":["Adjusted three-year overall survival 47.9 percent (95% CI 41.3 to 54.1) with a donor versus 26.6 percent (18.4 to 35.6) without (p 0.0001).","Three-year leukaemia-free survival 35.8 versus 20.6 percent (p 0.003).","Survival benefit consistent across all subgroups."],"whatItMeans":"Allogeneic transplant should be included in the management plan of fit older adults with higher-risk myelodysplastic syndrome; donor search should start at diagnosis.","caveats":["Assignment by donor availability rather than randomisation; not every donor-arm patient was transplanted and the analysis is by intention to treat.","Reduced-intensity conditioning only."],"changedPractice":true,"participants":384},"route":"/key-papers/paper-bmt-ctn-1102-transplant-older-mds-nakamura-jco-2021/","neighbours":{"cancer":[{"id":"mds-higher-risk","kind":"cancer","name":"Higher-risk myelodysplastic syndromes","route":"/cancers/mds-higher-risk/"},{"id":"mds","kind":"cancer","name":"Myelodysplastic syndromes / neoplasms (MDS)","route":"/cancers/mds/"}],"trial":[{"id":"bmt-ctn-1102","kind":"trial","name":"BMT CTN 1102","route":"/trials/bmt-ctn-1102/"}],"journal":[{"id":"jco","kind":"journal","name":"Journal of Clinical Oncology","route":"/journals/jco/"}]}}