[DanL]

I am in a similar situation. 2 rounds of Vidaza have not reduced my blast count, currently sitting at about 6%. I am scheduled for transplant the week of Feb 10th or 17th. We have 4 10/10 donors that have been tested, just doing some cross matching, all male, all younger, which is helpful from what I hear. I go in for what will probably be my last pre-transplant biopsy (#9) on Monday, go in for all of the pre-work this week.

There are quite a few studies available that compare Vidaza versus induction chemo, versus vidaza + induction chemo prior to transplant. The current information leans toward vidaza or induction, but not both. Almost all of these studies are retrospective in nature, meaning that they don't really take into account current results nor current approaches to patient care, which makes them informative, but not instructive.

The risk of a higher blast count is relapse, the risk of additional chemo to reduce the blast count is a weakened patient who is more susceptible to the inherent risks of transplant, so it like most things MDS, it is a combination of art and science.

Although I love to have numbers and reduce risk as much as possible, this is a point in my life where I am trusting my doctor and his team to make the right choices and for me to follow instructions as closely as possible to ensure the best results.

Lastly, there are a lot of transplants that are done, according to the registries, for patients that are in the RAEB - 2 category (higher blast count), so it is not uncommon for patients under 20% blast count to move forward to transplant.

Wishing you and your husband the very best as you go through these decisions.