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] = 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 = .006). However, after 1 year,
OS was not significantly different (HR, 1.38, P = .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.
Type
Journal articleSubject
Science & TechnologyLife Sciences & Biomedicine
Hematology
STEM-CELL TRANSPLANTATION
INTERNATIONAL WORKING GROUP
POLYCYTHEMIA-VERA
ESSENTIAL THROMBOCYTHEMIA
EUROPEAN GROUP
MYELOID METAPLASIA
SOCIETE FRANCAISE
PROGNOSTIC MODEL
PREDICT SURVIVAL
CURATIVE THERAPY
Permalink
https://hdl.handle.net/10161/20749Published Version (Please cite this version)
10.1182/bloodadvances.2019001084Publication Info
Gowin, Krisstina; Ballen, Karen; Ahn, Kwang Woo; Hu, Zhen-Huan; Ali, Haris; Arcasoy,
Murat O; ... Saber, Wael (2020). Survival following allogeneic transplant in patients with myelofibrosis. Blood advances, 4(9). pp. 1965-1973. 10.1182/bloodadvances.2019001084. Retrieved from https://hdl.handle.net/10161/20749.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
Collections
More Info
Show full item recordScholars@Duke
Murat Osman Arcasoy
Professor of Medicine
Dr. Arcasoy's research interests include 1)The role of cytokines and cytokine receptors
in hematopoietic commitment and lineage-specific differentiation 2) Mechanisms of
tissue-specific expression of erythropoietin receptor (EPOR) gene and its role in
lineage commitment and lineage-specific differentiation 3) Studies of the molecular
basis of familial and congenital myeloproliferative disorders.4). Isolation of novel
hematopoietic cytokine-responsive genes and study of their function and regulat

Articles written by Duke faculty are made available through the campus open access policy. For more information see: Duke Open Access Policy
Rights for Collection: Scholarly Articles
Works are deposited here by their authors, and represent their research and opinions, not that of Duke University. Some materials and descriptions may include offensive content. More info