Hematopoietic Cell Transplantation for Myelofibrosis: the Dynamic International Prognostic Scoring System Plus Risk Predicts Post-Transplant Outcomes

Bethany T. Samuelson Bannow, Rachel B. Salit, Barry E. Storer, Emily A. Stevens, David Wu, Cecilia Yeung, Min Fang, Effie W. Petersdorf, Michael L. Linenberger, Janghee Woo, Mohamed L. Sorror, Kris Doney, Brenda M. Sandmaier, H. Joachim Deeg, Bart L. Scott

Research output: Contribution to journalArticlepeer-review

28 Scopus citations

Abstract

Hematopoietic cell transplantation (HCT) provides potentially curative treatment for patients with myelofibrosis (MF). HCT outcomes are associated with the Dynamic International Prognostic Scoring System (DIPSS) risk scores. In the present study we analyzed results in 233 patients to determine if the DIPSS plus classification, which adds cytogenetics, thrombocytopenia, and RBC transfusion dependence as risk factors, would better predict post-HCT outcomes than the original DIPSS. Multivariate analysis showed that each risk parameter incorporated into the DIPPS plus model contributed to its predictive power of overall mortality, relapse-free survival, and nonrelapse mortality. The 5-year overall survival (OS), relapse, and treatment-related mortality (TRM) rates for patients with low/intermediate-1 risk MF were 78%, 5%, and 20%, respectively. The 5-year OS, relapse, and TRM rates for patients with high-risk MF were 35%, 28%, and 40%, respectively. The HCT-specific comorbidity index of 3 or greater was associated with higher nonrelapse and overall mortality and reduced relapse-free survival. The relapse incidence was significantly increased in older patients (HR, 3.02; P =.0007). With a median follow-up of 8 years 124 patients (53%) were surviving. The components of the DIPSS plus classification still have prognostic relevance after adjustment by the DIPSS classification. This information should enhance our ability to advise patients when making decisions regarding timing of transplant.

Original languageEnglish (US)
Pages (from-to)386-392
Number of pages7
JournalBiology of Blood and Marrow Transplantation
Volume24
Issue number2
DOIs
StatePublished - Feb 2018
Externally publishedYes

Keywords

  • DIPSS plus
  • Dynamic International Prognostic Scoring System (DIPSS)
  • Hematopoietic cell transplantation
  • Myelofibrosis

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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