title: Impact of allogeneic stem cell transplantation on survival of patients less than 65 years of age with primary myelofibrosis.
abstract: Allogeneic hematopoietic stem cell transplantation (SCT) is the only curative option for patients with primary myelofibrosis (PMF), but information on its net advantage over conventional therapies is lacking. Using ad hoc statistical analysis, we determined outcomes in 438 patients <65 years old at diagnosis who received allogenic SCT (n = 190) or conventional therapies (n = 248). Among patients at low risk per the Dynamic International Prognostic Scoring System (DIPSS) model, the relative risk of death after allogenic SCT vs those treated with nontransplant modalities was 5.6 (95% CI, 1.7-19; P = .0051); for intermediate-1 risk it was 1.6 (95% CI, 0.79-3.2; P = .19), for intermediate-2 risk, 0.55 (95% CI, 0.36-0.83; P = .005), and for high risk, 0.37 (95% CI, 0.21-0.66; P = .0007). Thus, patients with intermediate-2 or high-risk PMF clearly benefit from allogenic SCT. Patients at low risk should receive nontransplant therapy, whereas individual counseling is indicated for patients at intermediate-1 risk.
authors.affiliation: Department of Stem Cell Transplantation, University Hospital Hamburg, Hamburg, Germany;
authors.forename: Nicolaus
authors.identifier: http://orcid.org/0000-0001-5103-9966
authors.initials: N
authors.lastname: Kröger
authors.affiliation: Institute of Neurosciences, National Research Council of Italy, Padova, Italy;
authors.forename: Toni
authors.identifier: http://orcid.org/0000-0001-6449-0596
authors.initials: T
authors.lastname: Giorgino
authors.affiliation: Fred Hutchinson Cancer Research Center, Seattle, WA;
authors.forename: Bart L
authors.identifier: http://orcid.org/0000-0001-9620-7839
authors.initials: BL
authors.lastname: Scott
authors.affiliation: Department of Bone Marrow Transplantation, University Hospital Essen, Essen, Germany;
authors.forename: Markus
authors.initials: M
authors.lastname: Ditschkowski
authors.affiliation: Department of Stem Cell Transplantation, University Hospital Hamburg, Hamburg, Germany;
authors.forename: Haefaa
authors.initials: H
authors.lastname: Alchalby
authors.affiliation: Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain;
authors.forename: Francisco
authors.initials: F
authors.lastname: Cervantes
authors.affiliation: Università di Firenze, Firenze, Italy;
authors.forename: Alessandro
authors.initials: A
authors.lastname: Vannucchi
authors.affiliation: Università di Pavia, Pavia, Italy;
authors.forename: Mario
authors.initials: M
authors.lastname: Cazzola
authors.affiliation: Ospedale Niguarda Cà Granda, Milano, Italy; and.
authors.forename: Enrica
authors.initials: E
authors.lastname: Morra
authors.affiliation: Department of Stem Cell Transplantation, University Hospital Hamburg, Hamburg, Germany;
authors.forename: Tatjana
authors.initials: T
authors.lastname: Zabelina
authors.affiliation: Department of Medicine, Division of Hematology, University Hospital, Ospedale di Circolo, Varese, Italy.
authors.forename: Margherita
authors.initials: M
authors.lastname: Maffioli
authors.affiliation: Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain;
authors.forename: Arturo
authors.initials: A
authors.lastname: Pereira
authors.affiliation: Department of Bone Marrow Transplantation, University Hospital Essen, Essen, Germany;
authors.forename: Dietrich
authors.initials: D
authors.lastname: Beelen
authors.affiliation: Fred Hutchinson Cancer Research Center, Seattle, WA;
authors.forename: H Joachim
authors.initials: HJ
authors.lastname: Deeg
authors.affiliation: Department of Medicine, Division of Hematology, University Hospital, Ospedale di Circolo, Varese, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Passamonti
mesh_terms: D000328:Adult; D064591:Allografts; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D055728:Primary Myelofibrosis / Q000401:mortality* / Q000601:surgery*; D011379:Prognosis; D016016:Proportional Hazards Models; D055815:Young Adult