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Allogeneic hematopoietic cell transplantation in patients with myelofibrosis: A single center experience

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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.

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Acknowledgments

The authors thank patients, nurses, and physicians for their support with patients’ data and reports. Moreover, we thank all of our colleagues for helpful discussions. This study was supported by the Deutsche Krebshilfe (JU.S) (111548).

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  1. Department of Hematology and Oncology, Medical Center, University Hospital of Tuebingen, Tuebingen, 72076, Germany

    Joerg U. Schmohl, Christoph Faul, Wichard Vogel, Robert Möhle, Stefan Wirths, Dominik Schneidawind, Lothar Kanz & Wolfgang A. Bethge

  2. University of Minnesota, Masonic Cancer Center, Section of Molecular Cancer Therapeutics, University of Minnesota Masonic Cancer Center, Minneapolis, MN, USA

    Joerg U. Schmohl

  3. Department of Hematology and Oncology, Marienhospital, Stuttgart, 70199, Germany

    Christiane Groh

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Schmohl, J., Groh, C., Faul, C. et al. Allogeneic hematopoietic cell transplantation in patients with myelofibrosis: A single center experience. Ann Hematol 95, 973–983 (2016). https://doi.org/10.1007/s00277-016-2644-8

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