Is allogeneic stem cell transplantation for myelofibrosis still indicated at the time of molecular markers and JAK inhibitors era?

被引：7

作者：

Lestang, Elsa ^{[1
]}

Peterlin, Pierre ^{[1
]}

Le Bris, Yannick ^{[2
]}

Dubruille, Viviane ^{[1
]}

Delaunay, Jacques ^{[1
]}

Godon, Catherine ^{[2
]}

Theisen, Olivier ^{[2
]}

Blin, Nicolas ^{[1
]}

Mahe, Beatrice ^{[1
]}

Gastinne, Thomas ^{[1
]}

Garnier, Alice ^{[1
]}

Touzeau, Cyrille ^{[1
]}

Voldoire, Maud ^{[1
]}

Bene, Marie C. ^{[2
]}

Le Gouill, Steven ^{[1
]}

Milpied, Noel ^{[1
,3
]}

Mohty, Mohamad ^{[1
,4
]}

Moreau, Philippe ^{[1
]}

Guillaume, Thierry ^{[1
]}

Chevallier, Patrice ^{[1
]}

机构：

[1] CHU Hotel Dieu, Hematol Dept, Nantes, France

[2] CHU Hotel Dieu, Hematol Biol Dept, Nantes, France

[3] CHU Bordeaux, Dept Hematol, Bordeaux, France

[4] Hosp St Antoine, Dept Hematol, Paris, France

来源：

EUROPEAN JOURNAL OF HAEMATOLOGY | 2017年 / 99卷 / 01期

关键词：

allogeneic transplantation; calreticuline; intent-to-treat analysis; JAK inhibitor; JAK2; myeloproliferative leukemia virus; primary myelofibrosis; secondary myelofibrosis; INTERNATIONAL WORKING GROUP; MYELOPROLIFERATIVE NEOPLASMS RESEARCH; PROGNOSTIC SCORING SYSTEM; VERSUS-HOST-DISEASE; CELLULAIRE SFGM-TC; POLYCYTHEMIA-VERA; ESSENTIAL THROMBOCYTHEMIA; MYELOID METAPLASIA; SOCIETE FRANCAISE; IWG-MRT;

D O I：

10.1111/ejh.12891

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

ObjectiveThe role of allogenic stem cell transplantation (ASCT) is still debated in myelofibrosis (MF). MethodsA retrospective analyzed was performed to compare the outcome of 71 patients with intermediate-2 or high-risk Dynamic International Prognosis Scoring System+ (DIPSS+) primary (PMF) or secondary (SMF) myelofibrosis with an indication of ASCT as they ultimately underwent the procedure (n=34) or not (n=37). ResultsFive-year overall survival (OS) was not statistically different between both groups (allograft: 52% vs no allograft: 34%, P=.12). However, progression to myelodysplastic syndrome or acute myeloid leukemia at 5years was significantly lower in transplanted patients (14% vs 50%, P=.01). In univariate analysis, 5-year OS was significantly higher for transplanted vs non-transplanted patients with unfavorable karyotype (75% vs 0%, P=.001), SMF (71% vs 20%, P=.001) or high DIPSS+ score (46% vs 15%, P=.03). There was also a trend for better 5-year OS in allografted patients with high JAK2(V617F) burden (>65%) (75% vs 8%, P=.07). Interestingly, the survival of patients who did not proceed to ASCT was dramatically increased by the use of ruxolitinib. ConclusionsNot all intermediate-2/high-risk DIPSS+ MF patients benefit from ASCT, especially since the introduction of JAK2 inhibitors.

引用

页码：60 / 69

页数：10

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