Long-term outcome after allogeneic hematopoietic cell transplantation for myelofibrosis

Robin M, De Wreede LC, Wolschke C, Schetelig J, Eikema DJ, Van Lint MT, Knelange NS, Beelen D, Brecht A, Niederwieser D, Vitek A, Bethge W, Arnold R, Finke J, Volin L, Yakoub-Agha I, Nagler A, Poire X, Einsele H, Chevallier P, Holler E, Ljungman P, Robinson S, Radujkovic A, Mclornan D, Chalandon Y, Kroeger N (2019)

Publication Type: Journal article

Publication year: 2019

Journal

Book Volume: 104

Pages Range: 1782-1788

Journal Issue: 9

DOI: 10.3324/haematol.2018.205211

Abstract

Allogeneic hematopoietic stem cell transplant remains the only curative treatment for myelofibrosis. Most post-transplantation events occur during the first two years and hence we aimed to analyze the outcome of 2-year disease-free survivors. A total of 1055 patients with myelofibrosis transplanted between 1995 and 2014 and registered in the registry of the European Society for Blood and Marrow Transplantation were included. Survival was compared to the matched general population to determine excess mortality and the risk factors that are associated. In the 2-year survivors, disease-free survival was 64% (60-68%) and overall survival was 74% (71-78%) at ten years; results were better in younger individuals and in women. Excess mortality was 14% (8-21%) in patients aged <45 years and 33% (13-53%) in patients aged .65 years. The main cause of death was relapse of the primary disease. Graft-versus-host disease (GvHD) before two years decreased the risk of relapse. Multivariable analysis of excess mortality showed that age, male sex recipient, secondary myelofibrosis and no GvHD disease prior to the 2-year landmark increased the risk of excess mortality. This is the largest study to date analyzing long-term outcome in patients with myelofibrosis undergoing transplant. Overall it shows a good survival in patients alive and in remission at two years. However, the occurrence of late complications, including late relapses, infectious complications and secondary malignancies, highlights the importance of screening and monitoring of long-term survivors.

Involved external institutions

University of Paris 7 - Denis Diderot / Université Paris VII Denis Diderot France (FR) Leiden University Medical Center Netherlands (NL) Universitätsklinikum Hamburg-Eppendorf (UKE) Germany (DE) Universitätsklinikum Carl Gustav Carus Dresden Germany (DE) European Society for Blood and Marrow Transplantation EBMT Netherlands (NL) Ospedale San Martino (IRCCS AOU) Italy (IT) Universitätsklinikum Heidelberg Germany (DE) HELIOS Kliniken Germany (DE) Universitätsklinikum Leipzig Germany (DE) Institute of Hematology and Blood Transfusion (IHBT) / Ústav hematologie a krevní transfuze (ÚHKT) Czech Republic (CZ) Eberhard Karls Universität Tübingen Germany (DE) Charité - Universitätsmedizin Berlin Germany (DE) Albert-Ludwigs-Universität Freiburg Germany (DE) Helsinki University Central Hospital (HUCH) / Helsingin seudun yliopistollinen keskussairaala (HYKS) Finland (FI) Centre Hospitalier Régional Universitaire de Lille (CHRU de Lille) France (FR) Chaim Sheba Medical Center at Tel HaShomer / המרכז הרפואי עש חיים שיבא – תל השומר‎‎ Israel (IL) Cliniques universitaires Saint-Luc (CHU St-Luc) Belgium (BE) Universitätsklinikum Würzburg Germany (DE) Nantes University Hospital / Centre hospitalier universitaire de Nantes (CHU) France (FR) Universität Regensburg Germany (DE) Karolinska University Hospital / Karolinska Universitetssjukhuset Sweden (SE) University Hospitals Bristol NHS Foundation Trust United Kingdom (GB) Ruprecht-Karls-Universität Heidelberg Germany (DE) King’s College London United Kingdom (GB) University of Geneva / Université de Genève (UNIGE) Switzerland (CH)

How to cite

APA:

Robin, M., De Wreede, L.C., Wolschke, C., Schetelig, J., Eikema, D.-J., Van Lint, M.T.,... Kroeger, N. (2019). Long-term outcome after allogeneic hematopoietic cell transplantation for myelofibrosis. Haematologica, 104(9), 1782-1788. https://doi.org/10.3324/haematol.2018.205211

MLA:

Robin, Marie, et al. "Long-term outcome after allogeneic hematopoietic cell transplantation for myelofibrosis." Haematologica 104.9 (2019): 1782-1788.

BibTeX: Download