Outcome of Transplantation for Myelofibrosis

Karen K. Ballen, Smriti Shrestha, Kathleen A. Sobocinski, Mei Jie Zhang, Asad Bashey, Brian J. Bolwell, Francisco Cervantes, Steven M. Devine, Robert Peter Gale, Vikas Gupta, Theresa E. Hahn, William J. Hogan, Nicolaus Kröger, Mark R. Litzow, David I. Marks, Richard T. Maziarz, Philip L. McCarthy, Gary Schiller, Harry C. Schouten, Vivek RoyPeter H. Wiernik, Mary M. Horowitz, Sergio A. Giralt, Mukta Arora

Research output: Contribution to journalArticle

171 Scopus citations

Abstract

Myelofibrosis is a myeloproliferative disorder incurable with conventional strategies. Several small series have reported long-term disease-free survival (DSF) after allogeneic hematopoietic cell transplantation (HCT). In this study, we analyze the outcomes of 289 patients receiving allogeneic transplantation for primary myelofibrosis between 1989 and 2002, from the database of the Center for International Bone Marrow Transplant Research (CIBMTR). The median age was 47 years (range: 18-73 years). Donors were HLA identical siblings in 162 patients, unrelated individuals in 101 patients, and HLA nonidentical family members in 26 patients. Patients were treated with a variety of conditioning regimens and graft-versus-host disease (GVHD) prophylaxis regimens. Splenectomy was performed in 65 patients prior to transplantation. The 100-day treatment-related mortality was 18% for HLA identical sibling transplants, 35% for unrelated transplants, and 19% for transplants from alternative related donors. Corresponding 5-year overall survival (OS) rates were 37%, 30%, and 40%, respectively. DFS rates were 33%, 27%, and 22%, respectively. DFS for patients receiving reduced-intensity transplants was comparable: 39% for HLA identical sibling donors and 17% for unrelated donors at 3 years. In this large retrospective series, allogeneic transplantation for myelofibrosis resulted in long-term relapse-free survival (RFS) in about one-third of patients.

Original languageEnglish (US)
Pages (from-to)358-367
Number of pages10
JournalBiology of Blood and Marrow Transplantation
Volume16
Issue number3
DOIs
StatePublished - Mar 2010

Keywords

  • Allogeneic transplantation
  • Myelofibrosis

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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  • Cite this

    Ballen, K. K., Shrestha, S., Sobocinski, K. A., Zhang, M. J., Bashey, A., Bolwell, B. J., Cervantes, F., Devine, S. M., Gale, R. P., Gupta, V., Hahn, T. E., Hogan, W. J., Kröger, N., Litzow, M. R., Marks, D. I., Maziarz, R. T., McCarthy, P. L., Schiller, G., Schouten, H. C., ... Arora, M. (2010). Outcome of Transplantation for Myelofibrosis. Biology of Blood and Marrow Transplantation, 16(3), 358-367. https://doi.org/10.1016/j.bbmt.2009.10.025