Abstract
Background Bone marrow fibrosis in patients with myelodysplastic syndrome is associated with a poor outcome, but whether the outcome after allogeneic stem cell transplantation is related to the degree of bone marrow fibrosis is unknown. Design and Methods Patients with myelodysplastic syndrome and known bone marrow histology (n=721) who underwent hematopoietic stem cell transplantation were classified according to the degree of bone marrow fibrosis into those without fibrosis (n=483), those with mild or moderate fibrosis (n=199) and those with severe fibrosis (n=39) and analyzed regarding engraftment, treatmentrelated mortality, relapse and survival. Results The degree of fibrosis was not associated with disease status or abnormal cytogenetics. The cumulative incidence of engraftment achieved at day +30 in non-fibrotic patients was 93% and was significantly lower in those with mild or moderate fibrosis (89%) and severe fibrosis (75%) (P=0.009). Neutrophil engraftment occurred later in patients with mild or moderate fibrosis and severe fibrosis than in patients without fibrosis (median 17 versus 20 versus 16 days, respectively; P=0.002). The cumulative incidence of relapse at 3 years was significantly higher in patients with severe fibrosis than in those with a lesser degree of fibrosis or no fibrosis (47% versus 28% versus 27%, respectively; P=0.04), resulting in comparable 3-year disease-free survival rates in patients without fibrosis and in those with mild or moderate fibrosis (42% versus 38%, respectively) but a lower disease-free survival rate in those with severe fibrosis (18%; P=0.002). Severe fibrosis remained an independent factor for reduced survival (hazard ratio, 1.9; P=0.006). Conclusions Among patients with myelodysplastic syndromes, only severe fibrosis affects survival after hematopoietic stem cell transplantation while patients with mild or moderate fibrosis have an outcome comparable to that of patients without bone marrow fibrosis & copy 2011 Ferrata Storti Foundation. This is an open-access paper.
| Original language | English |
|---|---|
| Pages (from-to) | 291-297 |
| Number of pages | 7 |
| Journal | Haematologica |
| Volume | 96 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - Feb 2011 |
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Keywords
- Allogeneic stem cell transplantation
- Bone marrow fibrosis
- Engraftment
- Myelodysplastic syndromes
ASJC Scopus subject areas
- Hematology
Cite this
Allogeneic stem cell transplantation for myelodysplastic syndromes with bone marrow fibrosis. / Kröger, Nicolaus; Zabelina, Tatjana; van Biezen, Anja; Brand, Ronald; Niederwieser, Dietger; Martino, Rodrigo; Lim, Zi Yi; Onida, Francesco; Schmid, Christoph; Garderet, Laurent; Robin, Marie; van Gelder, Michael; Marks, Reinhard; Symeonidis, Argiris; Kobbe, Guido; de Witte, Theo.
In: Haematologica, Vol. 96, No. 2, 02.2011, p. 291-297.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Allogeneic stem cell transplantation for myelodysplastic syndromes with bone marrow fibrosis
AU - Kröger, Nicolaus
AU - Zabelina, Tatjana
AU - van Biezen, Anja
AU - Brand, Ronald
AU - Niederwieser, Dietger
AU - Martino, Rodrigo
AU - Lim, Zi Yi
AU - Onida, Francesco
AU - Schmid, Christoph
AU - Garderet, Laurent
AU - Robin, Marie
AU - van Gelder, Michael
AU - Marks, Reinhard
AU - Symeonidis, Argiris
AU - Kobbe, Guido
AU - de Witte, Theo
PY - 2011/2
Y1 - 2011/2
N2 - Background Bone marrow fibrosis in patients with myelodysplastic syndrome is associated with a poor outcome, but whether the outcome after allogeneic stem cell transplantation is related to the degree of bone marrow fibrosis is unknown. Design and Methods Patients with myelodysplastic syndrome and known bone marrow histology (n=721) who underwent hematopoietic stem cell transplantation were classified according to the degree of bone marrow fibrosis into those without fibrosis (n=483), those with mild or moderate fibrosis (n=199) and those with severe fibrosis (n=39) and analyzed regarding engraftment, treatmentrelated mortality, relapse and survival. Results The degree of fibrosis was not associated with disease status or abnormal cytogenetics. The cumulative incidence of engraftment achieved at day +30 in non-fibrotic patients was 93% and was significantly lower in those with mild or moderate fibrosis (89%) and severe fibrosis (75%) (P=0.009). Neutrophil engraftment occurred later in patients with mild or moderate fibrosis and severe fibrosis than in patients without fibrosis (median 17 versus 20 versus 16 days, respectively; P=0.002). The cumulative incidence of relapse at 3 years was significantly higher in patients with severe fibrosis than in those with a lesser degree of fibrosis or no fibrosis (47% versus 28% versus 27%, respectively; P=0.04), resulting in comparable 3-year disease-free survival rates in patients without fibrosis and in those with mild or moderate fibrosis (42% versus 38%, respectively) but a lower disease-free survival rate in those with severe fibrosis (18%; P=0.002). Severe fibrosis remained an independent factor for reduced survival (hazard ratio, 1.9; P=0.006). Conclusions Among patients with myelodysplastic syndromes, only severe fibrosis affects survival after hematopoietic stem cell transplantation while patients with mild or moderate fibrosis have an outcome comparable to that of patients without bone marrow fibrosis & copy 2011 Ferrata Storti Foundation. This is an open-access paper.
AB - Background Bone marrow fibrosis in patients with myelodysplastic syndrome is associated with a poor outcome, but whether the outcome after allogeneic stem cell transplantation is related to the degree of bone marrow fibrosis is unknown. Design and Methods Patients with myelodysplastic syndrome and known bone marrow histology (n=721) who underwent hematopoietic stem cell transplantation were classified according to the degree of bone marrow fibrosis into those without fibrosis (n=483), those with mild or moderate fibrosis (n=199) and those with severe fibrosis (n=39) and analyzed regarding engraftment, treatmentrelated mortality, relapse and survival. Results The degree of fibrosis was not associated with disease status or abnormal cytogenetics. The cumulative incidence of engraftment achieved at day +30 in non-fibrotic patients was 93% and was significantly lower in those with mild or moderate fibrosis (89%) and severe fibrosis (75%) (P=0.009). Neutrophil engraftment occurred later in patients with mild or moderate fibrosis and severe fibrosis than in patients without fibrosis (median 17 versus 20 versus 16 days, respectively; P=0.002). The cumulative incidence of relapse at 3 years was significantly higher in patients with severe fibrosis than in those with a lesser degree of fibrosis or no fibrosis (47% versus 28% versus 27%, respectively; P=0.04), resulting in comparable 3-year disease-free survival rates in patients without fibrosis and in those with mild or moderate fibrosis (42% versus 38%, respectively) but a lower disease-free survival rate in those with severe fibrosis (18%; P=0.002). Severe fibrosis remained an independent factor for reduced survival (hazard ratio, 1.9; P=0.006). Conclusions Among patients with myelodysplastic syndromes, only severe fibrosis affects survival after hematopoietic stem cell transplantation while patients with mild or moderate fibrosis have an outcome comparable to that of patients without bone marrow fibrosis & copy 2011 Ferrata Storti Foundation. This is an open-access paper.
KW - Allogeneic stem cell transplantation
KW - Bone marrow fibrosis
KW - Engraftment
KW - Myelodysplastic syndromes
UR - http://www.scopus.com/inward/record.url?scp=79551643588&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=79551643588&partnerID=8YFLogxK
U2 - 10.3324/haematol.2010.031229
DO - 10.3324/haematol.2010.031229
M3 - Article
VL - 96
SP - 291
EP - 297
JO - Haematologica
JF - Haematologica
SN - 0390-6078
IS - 2
ER -