TY  - JOUR
A1  - Hernández-Boluda, Juan-Carlos
A1  - Pereira, Arturo
A1  - Kröger, Nicolaus
A1  - Cornelissen, Jan J.
A1  - Finke, Jürgen
A1  - Beelen, Dietrich W.
A1  - Witte, Moniek de
A1  - Wilson, Keith
A1  - Platzbecker, Uwe
A1  - Sengeloev, Henrik
A1  - Blaise, Didier
A1  - Einsele, Hermann
A1  - Sockel, Katja
A1  - Krüger, William H.
A1  - Lenhoff, Stig
A1  - Salaroli, Adriano
A1  - Martin, Hans
A1  - García-Gutiérrez, Valentín
A1  - Pavone, Vicenzo
A1  - Alvarez-Larrán, Alberto
A1  - Raya, José-María
A1  - Zinger, Nienke
A1  - Gras, Luuk
A1  - Hayden, Patrick
A1  - Czerw, Tomasz
A1  - McLornan, Donal P.
A1  - Yakoub-Agha, Ibrahim
T1  - Allogeneic hematopoietic cell transplantation in older myelofibrosis patients: A study of the chronic malignancies working party of EBMT and the Spanish Myelofibrosis Registry
T2  - American journal of hematology
N2  - Allogeneic hematopoietic cell transplantation (allo-HCT) is increasingly used in older myelofibrosis (MF) patients, but its risk/benefit ratio compared to non-transplant approaches has not been evaluated in this population. We analyzed the outcomes of allo-HCT in 556 MF patients aged ≥65 years from the EBMT registry, and determined the excess mortality over the matched general population of MF patients ≥65 years managed with allo-HCT (n = 556) or conventional drug treatment (n = 176). The non-transplant cohort included patients with intermediate-2 or high risk DIPSS from the Spanish Myelofibrosis Registry. After a median follow-up of 3.4 years, the estimated 5-year survival rate, non-relapse mortality (NRM), and relapse incidence after transplantation was 40%, 37%, and 25%, respectively. Busulfan-based conditioning was associated with decreased mortality (HR: 0.7, 95% CI: 0.5–0.9) whereas the recipient CMV+/donor CMV- combination (HR: 1.7, 95% CI: 1.2–2.4) and the JAK2 mutated genotype (HR: 1.9, 95% CI: 1.1–3.5) predicted higher mortality. Busulfan-based conditioning correlated with improved survival due to less NRM, despite its higher relapse rate when compared with melphalan-based regimens. Excess mortality was higher in transplanted patients than in the non-HCT cohort in the first year of follow-up (ratio: 1.93, 95% CI: 1.13–2.80), whereas the opposite occurred between the fourth and eighth follow-up years (ratio: 0.31, 95% CI: 0.18–0.53). Comparing the excess mortality of the two treatments, male patients seemed to benefit more than females from allo-HCT, mainly due to their worse prognosis with non-transplant approaches. These findings could potentially enhance counseling and treatment decision-making in elderly transplant-eligible MF patients.
Y1  - 2021
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/63975
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-639757
SN  - 1096-8652
N1  - The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.
VL  - 96
IS  - 10
SP  - 1186
EP  - 1194
PB  - Wiley-Liss
CY  - New York, NY
ER  -