Choice of a different donor reduces relapse risk after second allogeneic SCT for MDS.

Choosing a different donor for second alloSCT in MDS patients significantly reduces relapse risk, with a hazard ratio of 0.56, improving disease control.

• Why it matters: Relapsed MDS after initial transplant has a poor prognosis, and current options for durable remission are limited, highlighting the need to optimize second transplant strategies.
• What they did: Analyzing 313 adults from 2012-2023, the study examined outcomes of alloSCT2, focusing on donor change, using multivariable models to assess relapse, survival, and mortality factors.
• The result: Donor change was linked to lower relapse risk, and recent years showed improved survival, although increased non-relapse mortality limited overall survival gains, guiding better donor selection.