TY - JOUR
T1 - Allogeneic blood or marrow transplantation with haploidentical donor and post-transplantation cyclophosphamide in patients with myelofibrosis
T2 - a multicenter study
AU - Kunte, Siddharth
AU - Rybicki, Lisa
AU - Viswabandya, Auro
AU - Tamari, Roni
AU - Bashey, Asad
AU - Keyzner, Alla
AU - Iqbal, Madiha
AU - Grunwald, Michael R.
AU - Dholaria, Bhagirathbhai
AU - Elmariah, Hany
AU - Ozga, Michael
AU - Singh, Anurag
AU - Abedin, Sameem
AU - DeZern, Amy E.
AU - Jones, Richard J.
AU - Gupta, Vikas
AU - Gerds, Aaron T.
AU - Jain, Tania
N1 - Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer Nature Limited.
PY - 2022/3
Y1 - 2022/3
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85117218470&partnerID=8YFLogxK
U2 - 10.1038/s41375-021-01449-1
DO - 10.1038/s41375-021-01449-1
M3 - Article
C2 - 34663912
AN - SCOPUS:85117218470
SN - 0887-6924
VL - 36
SP - 856
EP - 864
JO - Leukemia
JF - Leukemia
IS - 3
ER -