Background: The myelodysplastic syndromes(MDS) can be categorized as a group of clonal hematopoietlc disorders characterized by ineffective hematopoiesis and peripheral
cytopenias. Although the natural history of MDS varies, traditional treatments are not curative and allogeneic marrow transplantation offers potentially curative treatment for MDS.
Methods: In our center, 10 patients underwent allogeneic bons marrow transplantation(BMT) between December 1989 and May 1997. The minimum follow-up of 3 months was possible in 10 patisnts, for whom treatment-relatsd complications and
clinical outcomes were assessed.
Results: The median age of the 10 patients was 33(range 20∼40) years. The median time from diagnosis to BMT was 34(3∼116) months. By morphology, 5 patients had advanced MDS(i.e., RAEB, RAEB-t, CMML) and 5 patients had less advanced
MDS(RA). By Bournemouth score, 8 patients had a score 2∼3 and two patients had a score 4. By IPSS, 5 patients were in intermediate-1 group, 3 patients in intermediate-2
group and 2 patients in high risk group. Patients were prepared for transplant with either a total body irradiation(TBI)+cyclophosphamide(n=7), busulfan+TBl(n=2) and
busulfan+cyclophophamide(n=1). All patients received CsA+short course MTX for GVHD prophylaxis. Successful engraftment was confirmed in all patients. The overall incidence of acute GVHD was noted in 70%(7/10 patients) and grade Ⅳ scuts GVHD developed in 2 patients(20%). Fivs patients were evaluable for the development of chronic GVHD and 2 patients(40%) developed limited chronic GVHD. The duration of median follow-up was 8.1 months. At present five patients are alive and dlsease-free 3 to 21 months(median survival duration : 8.2 months) post- transplantation resulting in a 2-year disease-free
survival of 44%. 2-year disease free survival was 63% in less advanced MDS and 25% in advanced MDS.
Conclusion: Allogeneic BMT should be considered when any clinical evidence of disease progression to a more advanced stage becomes apparent. International prognostic scoring system(IPSS) and Bournemouth score can also be used to gauge timing for BMT. For patients were in intermediate-1 or intermediate-2 groups by IPSS, BMT can be justified if the ptient is young and has an HLA matched sibling donor.

Keywords: Myelodysplastic syndromes, Allogeneic bone marrow transplantation