| Literature DB >> 32384540 |
Krisstina Gowin1, Karen Ballen2, Kwang Woo Ahn3,4, Zhen-Huan Hu3, Haris Ali5, Murat O Arcasoy6, Rebecca Devlin7, Maria Coakley8, Aaron T Gerds9, Michael Green6, Vikas Gupta10, Gabriela Hobbs11, Tania Jain12, Malathi Kandarpa13, Rami Komrokji14, Andrew T Kuykendall14, Kierstin Luber15, Lucia Masarova16, Laura C Michaelis17, Sarah Patches18, Ashley C Pariser19, Raajit Rampal12, Brady Stein19, Moshe Talpaz16, Srdan Verstovsek16, Martha Wadleigh18, Vaibhav Agrawal20, Mahmoud Aljurf21, Miguel Angel Diaz22, Belinda R Avalos23, Ulrike Bacher24, Asad Bashey25, Amer M Beitinjaneh26, Jan Cerny27, Saurabh Chhabra3, Edward Copelan28, Corey S Cutler29, Zachariah DeFilipp30, Shahinaz M Gadalla31, Siddhartha Ganguly32, Michael R Grunwald23, Shahrukh K Hashmi21,33, Mohamed A Kharfan-Dabaja34, Tamila Kindwall-Keller2, Nicolaus Kröger35, Hillard M Lazarus36, Jane L Liesveld37, Mark R Litzow38, David I Marks39, Sunita Nathan40, Taiga Nishihori41, Richard F Olsson42,43, Attaphol Pawarode44, Jacob M Rowe45, Bipin N Savani46, Mary Lynn Savoie47, Sachiko Seo48, Melhem Solh49, Roni Tamari12, Leo F Verdonck50, Jean A Yared51, Edwin Alyea52, Uday Popat16, Ronald Sobecks53, Bart L Scott54, Ryotaro Nakamura55, Ruben Mesa56, Wael Saber3.
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] = 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 = .006). However, after 1 year, OS was not significantly different (HR, 1.38, P = .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.Entities:
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Year: 2020 PMID： 32384540 PMCID： PMC7218417 DOI： 10.1182/bloodadvances.2019001084
Source DB: PubMed Journal: Blood Adv ISSN： 2473-9529