title: Allogeneic hematopoietic cell transplantation in patients with myelofibrosis: A single center experience.
abstract: Myelofibrosis (MF) is a rare disease responsible for an increasing ineffective hematopoesis by a progressive fibrosing process in the bone marrow. The only curative treatment option is allogeneic hematopoietic cell transplantation (HCT). In this single-center analysis, we evaluated retrospectively 54 consecutive patients suffering from primary or secondary MF which underwent HCT from 1997 to 2014 after either myeloablative (MAC, n = 19) or reduced-intensity conditioning (RIC, n = 35). Overall survival (OS) and disease-free survival (DFS) after 3 years was 54/53 % for RIC versus 63/58 % for MAC (p = 0.8/0.97). Cumulative incidence of relapse was 34 % after RIC and 8 % after MAC (p = 0.16). Three-year non-relapse mortality (NRM) was 15 % after RIC and 34 % after MAC (p = 0.29). We found that RIC was associated with a lower incidence of acute graft versus host disease (GvHD; II-IV 26 vs. 0 %, p = 0.004). Evaluation of prognostic relevance of the Dynamic International Prognostic Scoring System (DIPSS) score showed a significant better OS in patient with risk score ≤3 versus >3 (after 3 years, 71 vs. 39 %, p = 0.008). While similar OS and DFS were observed with MAC or RIC, the use of RIC resulted in lower incidence of acute GvHD. RIC regimens may be therefore the preferred conditioning approach for allogeneic HCT in patients with MF.
authors.affiliation: Department of Hematology and Oncology, Medical Center, University Hospital of Tuebingen, Tuebingen, 72076, Germany.|University of Minnesota, Masonic Cancer Center, Section of Molecular Cancer Therapeutics, University of Minnesota Masonic Cancer Center, Minneapolis, MN, USA.
authors.forename: Joerg U
authors.initials: JU
authors.lastname: Schmohl
authors.affiliation: Department of Hematology and Oncology, Marienhospital, Stuttgart, 70199, Germany.
authors.forename: Christiane
authors.initials: C
authors.lastname: Groh
authors.affiliation: Department of Hematology and Oncology, Medical Center, University Hospital of Tuebingen, Tuebingen, 72076, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Faul
authors.affiliation: Department of Hematology and Oncology, Medical Center, University Hospital of Tuebingen, Tuebingen, 72076, Germany.
authors.forename: Wichard
authors.initials: W
authors.lastname: Vogel
authors.affiliation: Department of Hematology and Oncology, Medical Center, University Hospital of Tuebingen, Tuebingen, 72076, Germany.
authors.forename: Robert
authors.initials: R
authors.lastname: Möhle
authors.affiliation: Department of Hematology and Oncology, Medical Center, University Hospital of Tuebingen, Tuebingen, 72076, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Wirths
authors.affiliation: Department of Hematology and Oncology, Medical Center, University Hospital of Tuebingen, Tuebingen, 72076, Germany.
authors.forename: Dominik
authors.initials: D
authors.lastname: Schneidawind
authors.affiliation: Department of Hematology and Oncology, Medical Center, University Hospital of Tuebingen, Tuebingen, 72076, Germany.
authors.forename: Lothar
authors.initials: L
authors.lastname: Kanz
authors.affiliation: Department of Hematology and Oncology, Medical Center, University Hospital of Tuebingen, Tuebingen, 72076, Germany. wolfgang.bethge@med.uni-tuebingen.de.
authors.forename: Wolfgang A
authors.initials: WA
authors.lastname: Bethge
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000175:diagnosis / Q000401:mortality / Q000517:prevention & control; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods* / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D055728:Primary Myelofibrosis / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D012189:Retrospective Studies; D019172:Transplantation Conditioning / Q000379:methods* / Q000401:mortality; D014184:Transplantation, Homologous / Q000379:methods / Q000401:mortality
keywords: Hematopoietic cell transplantation; Myeloablative conditioning; Myelofibrosis; Reduced intensity conditioning