Science Highlights
Published on October 28, 2025
MAC vs. RIC for allo-HCT in older patients with MDS
by Nature
Loukili NH, Gras L, Koster L, et al. Conditioning Intensity in Myelodysplastic Patients Aged ≥ 50 Years Undergoing Allogeneic Hematopoietic Cell Transplantation: A Study on Behalf of the Chronic Malignancies Working Party of the EBMT. Bone Marrow Transplantation. 2025; (doi: 10.1038/s41409-025-02682-3).
Researchers compared outcomes with different conditioning regimens before allogeneic hematopoietic cell transplantation (allo-HCT) in patients ≥ 50 years with myelodysplastic syndromes/neoplasms (MDS). The team used the EBMT registry to form the dataset, which included 1,393 patients undergoing a first allo-HCT after myeloablative conditioning (MAC) or reduced-intensity conditioning (RIC) between 2014 and 2018. In all, 75.5%, or 1,053 patients, received RIC. Investigators actively explored subpopulations who might benefit from one approach or the other, but none emerged. There were no meaningful differences between MAC and RIC recipients across prespecified outcomes, including overall survival, event-free survival, relapse, and nonrelapse mortality. Neither technique was more beneficial to the target population than the other, a finding that dovetails with prior findings. With the debate over optimal conditioning strategy unresolved, the study authors suggested molecular profiling data might help identify appropriate subgroups for MAC or RIC in the future.
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