VA/VHAG alternating consolidation regimen combined with umbilical cord blood and mesenchymal stem cell infusion for the treatment of high-risk MDS patients who are unfit for transplantation: a case report and literature review

The only treatment option for high-risk MDS patients unfit for transplantation is continuous treatment with a hypomethylating agent (HMA). In this context, some new combination HMA regimens and other drugs with different mechanisms of action have been developed recently; however, no breakthroughs have been made. In our clinical practice, we have gradually explored various new methods-induction therapy with a modified VIALE-A (VA) regimen and an alternating regimen of modified VA and VHAG for the consolidation period. Some patients who were persistently positive for MRD were treated with HLA-mismatched umbilical cord blood, and patients with poor hematopoietic recovery additionally received mesenchymal stem cells infusion. Together, these treatments showed good efficacy. Here, the total treatment process for a typical patient is described, and a review of the literature is provided.