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Allogeneic blood or marrow transplantation with haploidentical donor and post-transplantation cyclophosphamide in patients with myelofibrosis: a multicenter study. Leukemia 2022 Mar;36(3):856-864

Date

10/20/2021

Pubmed ID

34663912

DOI

10.1038/s41375-021-01449-1

Scopus ID

2-s2.0-85117218470   7 Citations

Abstract

We report the results from a multicenter retrospective study of 69 adult patients who underwent haploidentical blood or marrow transplantation (haplo-BMT) with post-transplantation cyclophosphamide (PTCy) for chronic phase myelofibrosis. The median age at BMT was 63 years (range, 41-74). Conditioning regimens were reduced intensity in 54% and nonmyeloablative in 39%. Peripheral blood grafts were used in 86%. The median follow-up was 23.1 months (range, 1.6-75.7). At 3 years, the overall survival, relapse-free survival (RFS), and graft-versus-host-disease (GVHD)-free-RFS were 72% (95% CI 59-81), 44% (95% CI 29-59), and 30% (95% CI 17-43). Cumulative incidences of non-relapse mortality and relapse were 23% (95% CI 14-34) and 31% (95% CI 17-47) at 3 years. Spleen size ≥22 cm or prior splenectomy (HR 6.37, 95% CI 2.02-20.1, P = 0.002), and bone marrow grafts (HR 4.92, 95% CI 1.68-14.4, P = 0.004) were associated with increased incidence of relapse. Cumulative incidence of acute GVHD grade 3-4 was 10% at 3 months and extensive chronic GVHD was 8%. Neutrophil engraftment was reported in 94% patients, at a median of 20 days (range, 14-70). In conclusion, haplo-BMT with PTCy is feasible in patients with myelofibrosis. Splenomegaly ≥22 cm and bone marrow grafts were associated with a higher incidence of relapse in this study.

Author List

Kunte S, Rybicki L, Viswabandya A, Tamari R, Bashey A, Keyzner A, Iqbal M, Grunwald MR, Dholaria B, Elmariah H, Ozga M, Singh A, Abedin S, DeZern AE, Jones RJ, Gupta V, Gerds AT, Jain T

Author

Sameem Abedin MD Assistant Professor in the Medicine department at Medical College of Wisconsin




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

Adult
Aged
Bone Marrow Transplantation
Cyclophosphamide
Female
Graft vs Host Disease
Humans
Male
Middle Aged
Myeloablative Agonists
Neoplasm Recurrence, Local
Neutrophils
Primary Myelofibrosis
Retrospective Studies
Transplantation Conditioning
Transplantation, Homologous
Treatment Outcome