Survival following allogeneic transplant in patients with myelofibrosis Journal Article
| Authors: | Gowin, K.; Ballen, K.; Ahn, K. W.; Hu, Z. H.; Ali, H.; Arcasoy, M. O.; Devlin, R.; Coakley, M.; Gerds, A. T.; Green, M.; Gupta, V.; Hobbs, G.; Jain, T.; Kandarpa, M.; Komrokji, R.; Kuykendall, A. T.; Luber, K.; Masarova, L.; Michaelis, L. C.; Patches, S.; Pariser, A. C.; Rampal, R.; Stein, B.; Talpaz, M.; Verstovsek, S.; Wadleigh, M.; Agrawal, V.; Aljurf, M.; Diaz, M. A.; Avalos, B. R.; Bacher, U.; Bashey, A.; Beitinjaneh, A. M.; Cerny, J.; Chhabra, S.; Copelan, E.; Cutler, C. S.; DeFilipp, Z.; Gadalla, S. M.; Ganguly, S.; Grunwald, M. R.; Hashmi, S. K.; Kharfan-Dabaja, M. A.; Kindwall-Keller, T.; Kröger, N.; Lazarus, H. M.; Liesveld, J. L.; Litzow, M. R.; Marks, D. I.; Nathan, S.; Nishihori, T.; Olsson, R. F.; Pawarode, A.; Rowe, J. M.; Savani, B. N.; Savoie, M. L.; Seo, S.; Solh, M.; Tamari, R.; Verdonck, L. F.; Yared, J. A.; Alyea, E.; Popat, U.; Sobecks, R.; Scott, B. L.; Nakamura, R.; Mesa, R.; Saber, W. |
| Article Title: | Survival following allogeneic transplant in patients with myelofibrosis |
| Abstract: | Allogeneic hematopoietic cell transplantation (HCT) is the only curative therapy for myelofibrosis (MF). In this large multicenter retrospective study, overall survival (OS) in MF patients treated with allogeneic HCT (551 patients) and without HCT (non-HCT) (1377 patients) was analyzed with Cox proportional hazards model. Survival analysis stratified by the Dynamic International Prognostic Scoring System (DIPSS) revealed that the first year of treatment arm assignment, due to upfront risk of transplant-related mortality (TRM), HCT was associated with inferior OS compared with non-HCT (non-HCT vs HCT: DIPSS intermediate 1 [Int-1]: hazard ratio [HR] 5 0.26, P, .0001; DIPSS-Int-2 and higher: HR, 0.39, P, .0001). Similarly, in the DIPSS low-risk MF group, due to upfront TRM risk, OS was superior with non-HCT therapies compared with HCT in the first-year post treatment arm assignment (HR, 0.16, P 5 .006). However, after 1 year, OS was not significantly different (HR, 1.38, P 5 .451). Beyond 1 year of treatment arm assignment, an OS advantage with HCT therapy in Int-1 and higher DIPSS score patients was observed (non-HCT vs HCT: DIPSS-Int-1: HR, 2.64, P, .0001; DIPSS-Int-2 and higher: HR, 2.55, P, .0001). In conclusion, long-term OS advantage with HCT was observed for patients with Int-1 or higher risk MF, but at the cost of early TRM. The magnitude of OS benefit with HCT increased as DIPSS risk score increased and became apparent with longer follow-up. © 2020 American Society of Hematology. All rights reserved. |
| Keywords: | adult; aged; survival analysis; myelofibrosis; survival rate; major clinical study; overall survival; hydroxyurea; postoperative period; follow up; cohort analysis; retrospective study; polycythemia; allogeneic hematopoietic stem cell transplantation; immunomodulating agent; thrombocythemia; descriptive research; mortality rate; ruxolitinib; human; priority journal; article |
| Journal Title: | Blood Advances |
| Volume: | 4 |
| Issue: | 9 |
| ISSN: | 2473-9529 |
| Publisher: | American Society of Hematology |
| Date Published: | 2020-05-12 |
| Start Page: | 1965 |
| End Page: | 1973 |
| Language: | English |
| DOI: | 10.1182/bloodadvances.2019001084 |
| PUBMED: | 32384540 |
| PROVIDER: | scopus |
| PMCID: | PMC7218417 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 July 2020 -- Source: Scopus |
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