Myelodysplastic syndromes relapsing after allogeneic hematopoietic stem-cell transplantation are associated with poor 2-year OS that is significantly and independently influenced by history of acute graft-versus-host disease, relapse within 6 months after allo-SCT, progression to AML and platelet count < 50 g/L at relapse.
Immunotherapy (second allo-SCT or donor lymphocyte infusion) is the therapeutic of choice whenever possible.