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Divergent prognostic factors in high-risk vs. standard-risk patients aged 50–65 years after allo-HCT for AML/MDS: a single-center retrospective analysis

Bone Marrow Transplantation volume 60, pages 1175–1177 (2025)Cite this article

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Acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS) are the most prevalent malignant myeloid tumors, primarily affecting elderly patients who often have poor prognosis and face significant treatment challenges [1]. Allogeneic hematopoietic cell transplantation (allo-HCT) is the only curative treatment for high-risk AML or MDS [2]. The increasing number of elderly patients undergoing allo-HCT has raised new challenges [2].

Elderly patients with AML/MDS are intrinsically less sensitive to chemotherapy and are likely to have unfavorable risk factors, which often result in active disease status or positive minimal residual disease (MRD) before transplantation [3, 4]. The paradoxical relationship between disease relapse and treatment-related mortality is particularly evident among elderly patients [5]. Few studies have reported the differences in the prognosis of elderly patients with different levels of bone marrow (BM) blasts and MRD before transplantation. This retrospective study aimed to investigate the clinical outcomes of patients in different risk groups based on pretransplant BM blasts and MRD levels. Understanding these differences is crucial for optimizing treatment strategies and improving outcomes for elderly patients undergoing allo-HCT.

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Fig. 1: Analysis of Risk Factors in High-Risk and Standard-Risk Groups.

Data availability

The original contributions presented in the study were included in the article/Supplementary Material. Further inquiries can be directed to the corresponding author.

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Acknowledgements

The authors report no proprietary or commercial interest in any product mentioned or concept discussed in this article.

Funding

The study was supported by funds from Noncommunicable Chronic Diseases-National Science and Technology Major Project (2023ZD0502400); the CAMS Innovation Fund for Medical Sciences, CIFMS (2023-I2M-2-007); the National Natural Science Foundation of China (82070192 to ELJ; 82300249 to YGC); Haihe Laboratory of Cell Ecosystem Innovation Fund (22HHXBSS00034), and Tianjin Natural Science Foundation (23JCZXJC00220); Tianjin Health Science and Technology Project (No. TJWJ2022MS001 to YGC), Fundamental Research Funds for the Central Universities Funds (No.3332023058 to HYG, 2023-RW320-12 to YGC, 2023-I2M-C&T-B-108 to YWZ), National Clinical Research Center for Hematological Disorders (No. 2023NCRCA0105 to YGC).

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Authors and Affiliations

  1. State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, 300020, China

    Wenwen Guo, Haixiao Zhang, Hongye Gao, Yawei Zheng, Mingyang Wang, Wenbin Cao, Rongli Zhang, Qiaoling Ma, Yi He, Weihua Zhai, Donglin Yang, Aiming Pang, Sizhou Feng, Mingzhe Han, Yigeng Cao & Erlie Jiang

  2. Tianjin Institutes of Health Science, Tianjin, 301600, China

    Wenwen Guo, Haixiao Zhang, Hongye Gao, Yawei Zheng, Mingyang Wang, Wenbin Cao, Rongli Zhang, Qiaoling Ma, Yi He, Weihua Zhai, Donglin Yang, Aiming Pang, Sizhou Feng, Mingzhe Han, Yigeng Cao & Erlie Jiang

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  1. Wenwen Guo
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  2. Haixiao Zhang
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  3. Hongye Gao
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  15. Yigeng Cao
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  16. Erlie Jiang
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Contributions

ELJ and YGC designed and supervised the study. WWG and YGC performed the research. WWG analyzed the data and drafted the manuscript. WWG, HXZ, HYG, MYW, and YWZ collected data. WBC, RLZ, QLM, YH, WHZ, DLY, and AMP obtained clinical information. SZF, MZH, and ELJ interpreted the results and provided feedback. All authors contributed to the article and approved the submitted version.

Corresponding authors

Correspondence to Yigeng Cao or Erlie Jiang.

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The authors declare no competing interests.

Ethical approval and consent to participate

All methods were carried out in accordance with relevant guidelines and regulations. all experimental protocols were approved by the ethics committee of the Medical Ethics Committee at the Institute of Hematology & Blood Diseases Hospital. Written informed consent was obtained from all subjects and/or their legal guardian(s).

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Guo, W., Zhang, H., Gao, H. et al. Divergent prognostic factors in high-risk vs. standard-risk patients aged 50–65 years after allo-HCT for AML/MDS: a single-center retrospective analysis. Bone Marrow Transplant 60, 1175–1177 (2025). https://doi.org/10.1038/s41409-025-02619-w

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