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Outcome of transplantation for myelofibrosis. Biol Blood Marrow Transplant 2010 Mar;16(3):358-67 PMID: 19879949 PMCID: PMC2908949

Pubmed ID

19879949

Abstract

Myelofibrosis is a myeloproliferative disorder incurable with conventional strategies. Several small series have reported long-term disease-free survival (DSF) after allogeneic hematopoietic cell transplantation (HCT). In this study, we analyze the outcomes of 289 patients receiving allogeneic transplantation for primary myelofibrosis between 1989 and 2002, from the database of the Center for International Bone Marrow Transplant Research (CIBMTR). The median age was 47 years (range: 18-73 years). Donors were HLA identical siblings in 162 patients, unrelated individuals in 101 patients, and HLA nonidentical family members in 26 patients. Patients were treated with a variety of conditioning regimens and graft-versus-host disease (GVHD) prophylaxis regimens. Splenectomy was performed in 65 patients prior to transplantation. The 100-day treatment-related mortality was 18% for HLA identical sibling transplants, 35% for unrelated transplants, and 19% for transplants from alternative related donors. Corresponding 5-year overall survival (OS) rates were 37%, 30%, and 40%, respectively. DFS rates were 33%, 27%, and 22%, respectively. DFS for patients receiving reduced-intensity transplants was comparable: 39% for HLA identical sibling donors and 17% for unrelated donors at 3 years. In this large retrospective series, allogeneic transplantation for myelofibrosis resulted in long-term relapse-free survival (RFS) in about one-third of patients.

Author List

Ballen KK, Shrestha S, Sobocinski KA, Zhang MJ, Bashey A, Bolwell BJ, Cervantes F, Devine SM, Gale RP, Gupta V, Hahn TE, Hogan WJ, Kröger N, Litzow MR, Marks DI, Maziarz RT, McCarthy PL, Schiller G, Schouten HC, Roy V, Wiernik PH, Horowitz MM, Giralt SA, Arora M

Authors

Mary M. Horowitz MD, MS Center Director, Professor in the Medicine department at Medical College of Wisconsin
Mei-Jie Zhang PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin




Scopus

2-s2.0-75749125700   137 Citations

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Aged
Disease-Free Survival
Female
Graft Rejection
Graft Survival
Graft vs Host Disease
Hematopoietic Stem Cell Transplantation
Histocompatibility
Humans
Kaplan-Meier Estimate
Karnofsky Performance Status
Male
Middle Aged
Postoperative Complications
Primary Myelofibrosis
Recurrence
Retrospective Studies
Risk Factors
Siblings
Splenomegaly
Transplantation Conditioning
Transplantation, Homologous
Treatment Outcome
Young Adult
jenkins-FCD Prod-297 dff1a717c492f00bf6291286365f1f4fe95208f1