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    Survival following allogeneic transplant in patients with myelofibrosis

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    Author
    Gowin, K.
    Ballen, K.
    Yared, J.A.
    Date
    2020
    Journal
    Blood Advances
    Publisher
    American Society of Hematology
    Type
    Article
    
    Metadata
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    See at
    https://doi.org/10.1182/bloodadvances.2019001084
    Abstract
    Allogeneic hematopoietic cell transplantation (HCT) is the only curative therapy for myelofibrosis (MF). In this large multicenter retrospective study, overall survival (OS) in MF patients treated with allogeneic HCT (551 patients) and without HCT (non-HCT) (1377 patients) was analyzed with Cox proportional hazards model. Survival analysis stratified by the Dynamic International Prognostic Scoring System (DIPSS) revealed that the first year of treatment arm assignment, due to upfront risk of transplant-related mortality (TRM), HCT was associated with inferior OS compared with non-HCT (non-HCT vs HCT: DIPSS intermediate 1 [Int-1]: hazard ratio [HR] 5 0.26, P, .0001; DIPSS-Int-2 and higher: HR, 0.39, P, .0001). Similarly, in the DIPSS low-risk MF group, due to upfront TRM risk, OS was superior with non-HCT therapies compared with HCT in the first-year post treatment arm assignment (HR, 0.16, P 5 .006). However, after 1 year, OS was not significantly different (HR, 1.38, P 5 .451). Beyond 1 year of treatment arm assignment, an OS advantage with HCT therapy in Int-1 and higher DIPSS score patients was observed (non-HCT vs HCT: DIPSS-Int-1: HR, 2.64, P, .0001; DIPSS-Int-2 and higher: HR, 2.55, P, .0001). In conclusion, long-term OS advantage with HCT was observed for patients with Int-1 or higher risk MF, but at the cost of early TRM. The magnitude of OS benefit with HCT increased as DIPSS risk score increased and became apparent with longer follow-up.
    Keyword
    allogeneic hematopoietic cell transplantation
    Primary Myelofibrosis
    Transplantation
    Identifier to cite or link to this item
    https://www.scopus.com/inward/record.uri?eid=2-s2.0-85086108920&doi=10.1182%2fbloodadvances.2019001084&partnerID=40&md5=368d35203f15dc3c4948f23654c1377f; http://hdl.handle.net/10713/13095
    ae974a485f413a2113503eed53cd6c53
    10.1182/bloodadvances.2019001084
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