Ruxolitinib before allogeneic hematopoietic transplantation in patients with myelofibrosis on behalf SFGM-TC and FIM groups

被引:25
作者
Robin, Marie [1 ]
Porcher, Raphael [2 ,3 ]
Orvain, Corentin [4 ]
Bay, Jacques-Olivier [5 ]
Barraco, Fiorenza [6 ]
Huynh, Anne [7 ]
Charbonnier, Amandine [8 ]
Forcade, Edouard [9 ]
Chantepie, Sylvain [10 ]
Bulabois, Claude [11 ]
Yakoub-Agha, Ibrahim [12 ]
Detrait, Marie [13 ]
Michonneau, David [14 ]
Turlure, Pascal [15 ]
Raus, Nicole [16 ]
Boyer, Francoise [4 ]
Suarez, Felipe [17 ]
Vincent, Laure [18 ]
Guyen, Stephanie N. [19 ]
Cornillon, Jerome [20 ]
Villate, Alban [21 ]
Dupriez, Brigitte [22 ]
Cassinat, Bruno [23 ]
Rolland, Valerie [24 ]
Schlageter, Marie Helene [23 ]
Socie, Gerard [14 ]
Kiladjian, Jean-Jacques [25 ]
机构
[1] Hop St Louis, AP HP, Serv Hematol Greffe, Paris, France
[2] Univ Paris, INSERM, Epidemiol & Stat Res Ctr CRESS, INRA, Paris, France
[3] Hop Hotel Dieu, AP HP, Ctr Epidemiol Clin, Paris, France
[4] CHU Angers, Angers, France
[5] CHU Clermont Ferrand, Clermont Ferrand, France
[6] CHU Lyon Sud, Lyon, France
[7] CHU Toulouse, Toulouse, France
[8] CHU Amiens, Amiens, France
[9] CHU Bordeaux, Serv Hematol & Therapie Cellulaire, Bordeaux, France
[10] CHU Caen, Caen, France
[11] CHU Grenoble Alpes, Grenoble, France
[12] Univ Lille, CHU Lille, INSERM U1286, Infinite, Lille, France
[13] Univ Lorraine, Inst Louis Mathieu, CHRU Nancy, Vandoeuvre Les Nancy, France
[14] Univ Paris, Serv Hematol Greffe, Hop St Louis, AP HP,U976, Paris, France
[15] CHU Limoges, Limoges, France
[16] Hop Lyon Sud, SFGM TC, Lyon, France
[17] CHU, Hop Necker, AP HP, Paris, France
[18] CHU Montpellier, Hop St Eloi, Montpellier, France
[19] Hop La Pitie Salpetriere, APHP, Paris, France
[20] Inst Cancerol Loire, St Etienne, France
[21] CHRU Tours, Hop Bretonneau, Tours, France
[22] Ctr Hosp, Route Bassee, Lens, France
[23] Hop St Louis, AP HP, Lab Biol Cellulaire, Paris, France
[24] CHU Lyon Sud, FILO, Lyon, France
[25] Hop St Louis, AP HP, Ctr Invest Clin, Paris, France
关键词
D O I
10.1038/s41409-021-01252-7
中图分类号
Q6 [生物物理学];
学科分类号
071011 ;
摘要
This multicenter prospective phase 2 trial analyzed disease-free survival (DFS) in myelofibrosis patients receiving ruxolitinib for 6 months before transplantation. Seventy-six patients were recruited. Age-adjusted dynamic international prognostic scoring system was intermediate-1, intermediate-2, and high in 27 (36%), 31 (41%), and 18 (24%) patients. All patients received ruxolitinib from inclusion to conditioning regimen (fludarabine-melphalan) or to progression. A donor was found in 64 patients: 18 HLA-matched sibling donor (MSD), 32 HLA-matched unrelated (UD10/10), and 14 HLA mismatched unrelated donor (UD9/10. Among 64 patients with a donor, 20 (31%) achieved a partial response before transplantation and 59 (92%) could be transplanted after ruxolitinib therapy (18/18 MSD, 30/21 UD10/10, 11/34 UD9/10), of whom 19 (32%) were splenectomized. Overall survival from inclusion was 68% at 12 months. One-year DFS after transplantation was 55%: 83%, 40%, and 34% after MSD, UD10/10 or UD9/10, respectively. Cumulative incidence of grade 2-4 acute graft-versus-host disease (GVHD) was 66% and non-relapse-mortality was 42% at 12 months. Short course of ruxolitinib before transplantation is followed by a high rate of transplantation. With the platform used in this protocol, outcome was much better in patients transplanted with HLA-matched sibling donor as compared to unrelated donor.
引用
收藏
页码:1888 / 1899
页数:12
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