Allogeneic Transplantation for Patients with Advanced Myelofibrosis: Splenomegaly and High Serum LDH are Adverse Risk Factors for Successful Engraftment

Publication date: Available online 18 February 2016 Source:Clinical Lymphoma Myeloma and Leukemia Author(s): Usama Gergis, Emil Kuriakose, Tsiporah Shore, Sebastian Mayer, Tomer Mark, Roger Pearse, Michael Schuster, Eric Feldman, Gail Roboz, Ellen Ritchie, Joseph Scandura, Hanhan Wang, Xi Kathy Zhou, Richard T. Silver, Koen van Besien Thirty consecutive patients underwent hematopoietic stem cell transplantation (HSCT) for myelofibrosis (MF) at our institution. The median age at transplant was 49 years (range, 18-68), 74% of patients had advanced dynamic international prognostic scoring system (DIPPS), and 83% received reduced intensity conditioning (RIC). Neutrophil engraftment was achieved in 27 patients (90%) at a median time of 15 days (range, 10-44), and nineteen patients (63%) achieved platelet recovery at a median time of 18 days (range, 8-100). Splenomegaly was associated with poor neutrophil engraftment (SHR=0.42, 95%CI: 0.21 - 0.83, p=0.01) and platelet engraftment (SHR=0.18, 95%CI: 0.07-0.48, p<0.001). Elevated LDH was associated with poor platelet engraftment (SHR=0.39, 95%CI: 0.16 - 0.94, p=0.04). The median follow up for surviving patients was 49 months (range, 3–155). The one-year cumulative incidence of non-relapse mortality (NRM) and relapse were respectively, 57% (95% CI: 29-76%) and 25% (95% CI: 7-48 %). Elevated LDH was associated with high NRM (SHR=2.82, 95%CI: 1.08 - 7.35, p=0.03). The 4-year overall survival (OS...
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research