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Allogeneic hematopoietic cell transplantation for advanced polycythemia vera and essential thrombocythemia. Biol Blood Marrow Transplant 2012 Sep;18(9):1446-54 PMID: 22449610 PMCID: PMC3499973

Pubmed ID

22449610

Abstract

Allogeneic hematopoietic cell transplantation (HCT) is curative for selected patients with advanced essential thrombocythemia (ET) or polycythemia vera (PV). From 1990 to 2007, 75 patients with ET (median age 49 years) and 42 patients with PV (median age 53 years) underwent transplantations at the Fred Hutchinson Cancer Research Center (FHCRC; n = 43) or at other Center for International Blood and Marrow Transplant Research (CIBMTR) centers (n = 74). Thirty-eight percent of the patients had splenomegaly and 28% had a prior splenectomy. Most patients (69% for ET and 67% for PV) received a myeloablative (MA) conditioning regimen. Cumulative incidence of neutrophil engraftment at 28 days was 88% for ET patients and 90% for PV patients. Acute graft-versus-host disease (aGVHD) grades II to IV occurred in 57% and 50% of ET and PV patients, respectively. The 1-year treatment-related mortality (TRM) was 27% for ET and 22% for PV. The 5-year cumulative incidence of relapse was 13% for ET and 30% for PV. Five-year survival/progression-free survival (PFS) was 55%/47% and 71%/48% for ET and PV, respectively. Patients without splenomegaly had faster neutrophil and platelet engraftment, but there were no differences in TRM, survival, or PFS. Presence of myelofibrosis (MF) did not affect engraftment or TRM. Over 45% of the patients who undergo transplantations for ET and PV experience long-term PFS.

Author List

Ballen KK, Woolfrey AE, Zhu X, Ahn KW, Wirk B, Arora M, George B, Savani BN, Bolwell B, Porter DL, Copelan E, Hale G, Schouten HC, Lewis I, Cahn JY, Halter J, Cortes J, Kalaycio ME, Antin J, Aljurf MD, Carabasi MH, Hamadani M, McCarthy P, Pavletic S, Gupta V, Deeg HJ, Maziarz RT, Horowitz MM, Saber W

Authors

Kwang Woo Ahn PhD Associate Professor in the Institute for Health and Equity department at Medical College of Wisconsin
Mehdi H. Hamadani MD Professor in the Medicine department at Medical College of Wisconsin
Mary M. Horowitz MD, MS Center Director, Professor in the Medicine department at Medical College of Wisconsin
Wael Saber MD, MS Associate Professor in the Medicine department at Medical College of Wisconsin




Scopus

2-s2.0-84865198731   12 Citations

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

Acute Disease
Adult
Female
Graft vs Host Disease
Hematopoietic Stem Cell Transplantation
Humans
Longitudinal Studies
Male
Middle Aged
Myeloablative Agonists
Neutrophils
Polycythemia Vera
Recurrence
Splenectomy
Splenomegaly
Survival Analysis
Thrombocythemia, Essential
Transplantation Conditioning
Transplantation, Homologous
jenkins-FCD Prod-296 4db9d02597e0a2e889e230f853b641c12f1c3ee3