Impact of prior JAK-inhibitor therapy with ruxolitinib on outcome after allogeneic hematopoietic stem cell transplantation for myelofibrosis: a study of the CMWP of EBMT

Nicolaus Kröger, Giulia Sbianchi, Tiarlan Sirait, Christine Wolschke, Dietrich Beelen, Jakob Passweg, Marie Robin, Radovan Vrhovac, Grzegorz Helbig, Katja Sockel, Eibhlin Conneally, Marie Thérèse Rubio, Yves Beguin, Jürgen Finke, Paolo Bernasconi, Elena Morozova, Johannes Clausen, Peter von dem Borne, Nicolaas Schaap, Wilfried SchroyensFrancesca Patriarca, Nicola Di Renzo, Zeynep Arzu Yeğin, Patrick Hayden, Donal McLornan, Ibrahim Yakoub-Agha

Research output: Contribution to journalArticlepeer-review

Abstract

JAK1/2 inhibitor ruxolitinib (RUX) is approved in patients with myelofibrosis but the impact of pretreatment with RUX on outcome after allogeneic hematopoietic stem cell transplantation (HSCT) remains to be determined. We evaluated the impact of RUX on outcome in 551 myelofibrosis patients who received HSCT without (n = 274) or with (n = 277) RUX pretreatment. The overall leukocyte engraftment on day 45 was 92% and significantly higher in RUX responsive patients than those who had no or lost response to RUX (94% vs. 85%, p = 0.05). The 1-year non-relapse mortality was 22% without significant difference between the arms. In a multivariate analysis (MVA) RUX pretreated patients with ongoing spleen response at transplant had a significantly lower risk of relapse (8.1% vs. 19.1%; p = 0.04)] and better 2-year event-free survival (68.9% vs. 53.7%; p = 0.02) in comparison to patients without RUX pretreatment. For overall survival the only significant factors were age > 58 years (p = 0.03) and HLA mismatch donor (p = 0.001). RUX prior to HSCT did not negatively impact outcome after transplantation and patients with ongoing spleen response at time of transplantation had best outcome.

Original languageEnglish
JournalLeukemia
DOIs
Publication statusAccepted/In press - 2021

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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