TY - JOUR
T1 - Determinants of survival in myelofibrosis patients undergoing allogeneic hematopoietic cell transplantation
AU - Hernández-Boluda, Juan Carlos
AU - Pereira, Arturo
AU - Kröger, Nicolaus
AU - Beelen, Dietrich
AU - Robin, Marie
AU - Bornhäuser, Martin
AU - Angelucci, Emanuele
AU - Vitek, Antonin
AU - Blau, Igor Wolfgang
AU - Niittyvuopio, Riitta
AU - Finke, Jürgen
AU - Cornelissen, Jan J.
AU - Passweg, Jakob
AU - Dreger, Peter
AU - Petersen, Eefke
AU - Kanz, Lothar
AU - Sanz, Jaime
AU - Zuckerman, Tsila
AU - Zinger, Nienke
AU - Iacobelli, Simona
AU - Hayden, Patrick
AU - Czerw, Tomasz
AU - McLornan, Donal
AU - Yakoub-Agha, Ibrahim
PY - 2020/1/1
Y1 - 2020/1/1
N2 - We aimed to evaluate the determinants of survival in myelofibrosis patients undergoing allogeneic hematopoietic cell transplantation (allo-HCT) and to describe factors predicting the main post-HCT complications. This retrospective study by the European Society for Blood and Marrow Transplantation included 2916 myelofibrosis patients who underwent first allo-HCT from an HLA-identical sibling or unrelated donor between 2000 and 2016. After a median follow-up of 4.7 years from transplant, projected median survival of the series was 5.3 years. Factors independently associated with increased mortality were age ≥ 60 years and Karnofsky Performance Status <90% at transplant, and occurrence of graft failure, grades III–IV acute graft-vs.-host disease (aGVHD), and disease progression/relapse during follow-up. The opposing effects of chronic graft-vs.-host disease (GVHD) on non-relapse mortality and relapse incidence resulted in a neutral influence on survival. Graft failure increased in unrelated donor recipients and decreased with myeloablative conditioning (MAC) and negative donor/recipient cytomegalovirus serostatus. Risk of grades III–IV aGVHD was higher with unrelated donors and decreased with MAC. Relapse incidence tended to be higher in patients with intermediate-2/high-risk DIPSS categories and to decrease in CALR-mutated patients. Acute and chronic GVHD reduced the subsequent risk of relapse. This information has potential implications for patient counseling and clinical decision-making.
AB - We aimed to evaluate the determinants of survival in myelofibrosis patients undergoing allogeneic hematopoietic cell transplantation (allo-HCT) and to describe factors predicting the main post-HCT complications. This retrospective study by the European Society for Blood and Marrow Transplantation included 2916 myelofibrosis patients who underwent first allo-HCT from an HLA-identical sibling or unrelated donor between 2000 and 2016. After a median follow-up of 4.7 years from transplant, projected median survival of the series was 5.3 years. Factors independently associated with increased mortality were age ≥ 60 years and Karnofsky Performance Status <90% at transplant, and occurrence of graft failure, grades III–IV acute graft-vs.-host disease (aGVHD), and disease progression/relapse during follow-up. The opposing effects of chronic graft-vs.-host disease (GVHD) on non-relapse mortality and relapse incidence resulted in a neutral influence on survival. Graft failure increased in unrelated donor recipients and decreased with myeloablative conditioning (MAC) and negative donor/recipient cytomegalovirus serostatus. Risk of grades III–IV aGVHD was higher with unrelated donors and decreased with MAC. Relapse incidence tended to be higher in patients with intermediate-2/high-risk DIPSS categories and to decrease in CALR-mutated patients. Acute and chronic GVHD reduced the subsequent risk of relapse. This information has potential implications for patient counseling and clinical decision-making.
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U2 - 10.1038/s41375-020-0815-z
DO - 10.1038/s41375-020-0815-z
M3 - Article
C2 - 32286544
AN - SCOPUS:85083468746
JO - Leukemia
JF - Leukemia
SN - 0887-6924
ER -