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40%; relapse risk relates to IPSS score—low risk <5%, high risk >25% as does DFS—IPSS low/intermediate-1 60%, intermediate-2 36% and high risk 28% at 5 years; favourable outcome associated with younger age, shorter disease duration, compatible graft, primary MDS, <10% blasts, good risk cytogenetics; lower intensity non-myeloablative regimens under trial for toxicity and response rate and may increase age range to 65 years.

• MUD allogeneic SCT associated with lower DFS (<30% at 2 years), higher treatment related mortality (>50%) but lower relapse rates (<15%); high mortality associated with patient age; this treatment should be discussed with patients <40 with >IPSS intermediate-1 who lack a sibling donor.

• Autologous SCT under trial for patients in CR after AML regimens; poor harvests; low TRM; high relapse rate.

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