Synapse - CD34+ -selected hematopoietic stem cell transplant conditioned with a myeloablative regimen in patients with advanced myelofibrosis

CD34+ -selected hematopoietic stem cell transplant conditioned with a myeloablative regimen in patients with advanced myelofibrosis Journal Article

Authors:	Nawas, M. T.; Lee, J. O.; Flynn, J.; Maloy, M.; Jakubowski, A. A.; Papadopoulos, E. B.; Cho, C.; Ponce, D. M.; Sauter, C. S.; Perales, M. A.; Devlin, S.; Giralt, S. A.; Castro-Malaspina, H. R.; Tamari, R.
Article Title:	CD34+ -selected hematopoietic stem cell transplant conditioned with a myeloablative regimen in patients with advanced myelofibrosis
Abstract:	Allogeneic hematopoietic stem cell transplantation (Allo-HCT) remains the only curative treatment for myelofibrosis (MF). Transplantation in patients with MF is mostly done using a reduced intensity conditioning regimen with calcineurin inhibitors for graft versus host disease (GVHD) prophylaxis. Here we sought to evaluate outcomes of patients who underwent an ex vivo CD34+ -selected allo-HCT using myeloablative conditioning (MAC). Twenty-seven patients were included in this retrospective analysis. All patients were conditioned with busulfan, melphalan and fludarabine and antithymocyte globulin to prevent graft rejection. G-CSF mobilized peripheral blood stem cell grafts were depleted of T-cells using immunomagnetic CD34+ selection by CliniMACS device. Median follow-up among survivors was 50.6 months. The estimated 3-year overall survival, relapse free survival and the combined endpoint of GVHD/relapse free survival were 88% (95% CI, 75–100%), 80% (95% CI, 66–98%) and 74% (95% CI, 59–93%), respectively. The cumulative incidence of grade II-IV acute GVHD at day 100 was 33.3% (95% CI 16.4–51.3%), and two patients suffered chronic GVHD. There were no cases of primary graft failure. However, delayed graft failure occurred in two patients. We conclude that CD34+ selected allo-HCT with a MAC resulted in high survival rates in this cohort of patients with MF. © 2022, The Author(s), under exclusive licence to Springer Nature Limited.
Keywords:	adult; clinical article; controlled study; aged; middle aged; myelofibrosis; survival rate; retrospective studies; transplantation, homologous; overall survival; busulfan; fludarabine; myeloid metaplasia; primary myelofibrosis; nonhuman; outcome assessment; follow up; t lymphocyte; cd34 antigen; cohort analysis; melphalan; steroid; hematopoietic stem cell transplantation; retrospective study; survivor; acute graft versus host disease; chronic graft versus host disease; graft failure; myeloablative conditioning; peripheral blood stem cell; graft versus host reaction; transplantation conditioning; allogeneic hematopoietic stem cell transplantation; graft rejection; t cell depletion; tacrolimus; graft vs host disease; ex vivo study; granulocyte colony stimulating factor; antigens, cd34; allotransplantation; thymocyte antibody; virus reactivation; infectious complication; recurrence free survival; cumulative incidence; budesonide; procedures; mycophenolate mofetil; ruxolitinib; humans; human; male; female; article; delayed graft function; immunomagnetic cell separation
Journal Title:	Bone Marrow Transplantation
Volume:	57
Issue:	7
ISSN:	0268-3369
Publisher:	Nature Publishing Group
Date Published:	2022-07-01
Start Page:	1101
End Page:	1107
Language:	English
DOI:	10.1038/s41409-022-01684-9
PUBMED:	35484207
PROVIDER:	scopus
PMCID:	PMC10015419
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-85129102130&doi=10.1038%2fs41409-022-01684-9&partnerID=40&md5=7e914df070263baae84a01c99068d1f7
Notes:	Article -- Export Date: 1 August 2022 -- Source: Scopus