In:
American Journal of Hematology, Wiley, Vol. 98, No. 4 ( 2023-04), p. 628-638
Abstract:
Allogeneic hematopoietic cell transplant (allo‐HCT) provides the only potential route to long‐term remission in patients diagnosed with blast phase transformation of myeloproliferative neoplasm (BP‐MPN). We report on a large, retrospective European Society for Blood and Marrow Transplantation registry‐based study of BP‐MPN patients undergoing allo‐HCT. BP‐MPN patients undergoing first allo‐HCT between 2005 and 2019 were included. A total of 663 patients were included. With a median follow‐up of 62 months, the estimated 3‐year overall survival (OS) was 36% (95% confidence interval [CI], 32–36). Factors associated with lower OS were Karnofsky Performance Score (KPS) 〈 90 (hazard ratio [HR] 1.65, p 〈 .001) and active disease at allo‐HCT (HR 1.45, p 〈 .001), whereas patients undergoing allo‐HCT more recently associated with a higher OS (HR 0.96, p = .008). In a selected patient's population, the 3‐year OS of patients undergoing allo‐HCT in complete response (CR) and with a KPS ≥90 was 60%. KPS 〈 90 (HR 1.4, p = .001) and active disease (HR 1.44, p = .0004) were associated with a lower progression‐free survival (PFS). Conversely, most recent allo‐HCT associated with a higher PFS (HR 0.96, p = .008). Active disease at allo‐HCT (HR 1.34, p = .03) was associated with a higher cumulative incidence of relapse (RI) and allo‐HCT in earlier calendar years (HR 0.96, p = .02) associated with a lower RI. Last, KPS 〈 90 (HR 1.91, p 〈 .001), active disease (HR 1.74, p = .003) and allo‐HCT from mismatched related donors were associated with a higher non‐relapse mortality (HR 2.66, p = .003). In this large series of BP‐MPN patients, about one third were alive at 3 years after transplantation. Patients undergoing allo‐HCT in the more recent era, with a KPS ≥90 and in CR at transplant had a better prognosis.
Type of Medium:
Online Resource
ISSN:
0361-8609
,
1096-8652
Language:
English
Publisher:
Wiley
Publication Date:
2023
detail.hit.zdb_id:
1492749-4