TY - JOUR
T1 - Outcomes following second allogeneic haematopoietic cell transplantation in patients with myelofibrosis
T2 - a retrospective study of the Chronic Malignancies Working Party of EBMT
AU - Nabergoj, Mitja
AU - Mauff, Katya
AU - Robin, Marie
AU - Kröger, Nicolaus
AU - Angelucci, Emanuele
AU - Poiré, Xavier
AU - Passweg, Jakob
AU - Radujkovic, Aleksandar
AU - Platzbecker, Uwe
AU - Robinson, Stephen
AU - Rambaldi, Alessandro
AU - Petersen, Søren Lykke
AU - Stölzel, Fridrich
AU - Stelljes, Matthias
AU - Ciceri, Fabio
AU - Mayer, Jiri
AU - Ladetto, Marco
AU - de Wreede, Liesebeth C.
AU - Koster, Linda
AU - Hayden, Patrick J.
AU - Czerw, Tomasz
AU - Hernández-Boluda, Juan Carlos
AU - McLornan, Donal
AU - Chalandon, Yves
AU - Yakoub-Agha, Ibrahim
N1 - Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer Nature Limited.
PY - 2021/8
Y1 - 2021/8
N2 - Therapeutic management of patients with primary or secondary myelofibrosis (MF) who experience relapse or graft failure following allogeneic haematopoietic cell transplantation (allo-HCT) remains heterogeneous. We retrospectively analyzed 216 patients undergoing a second allo-HCT for either relapse (56%) or graft failure (31%) between 2010 and 2017. Median age was 57.3 years (range 51–63). The same donor as for the first allo-HCT was chosen in 66 patients (31%) of whom 19 received an HLA-identical sibling donor, whereas a different donor was chosen for 116 patients (54%). Median follow-up was 40 months. Three-year overall survival (OS) and relapse-free survival (RFS) were 42% and 39%, respectively. Three-year non-relapse mortality (NRM) and relapse rates were 36% and 25%, respectively. Grade II-IV and III-IV acute GVHD occurred in 25% and 11% of patients, respectively, and the 3-year incidence of chronic GVHD was 33% including 14% for extensive grade. Graft-failure incidence at 1 year was 14%. In conclusion, our data suggest that a second allo-HCT is a potential option for patients failing first allo-HCT for MF albeit careful patient assessment is fundamental to identify individual patients who could benefit from this approach.
AB - Therapeutic management of patients with primary or secondary myelofibrosis (MF) who experience relapse or graft failure following allogeneic haematopoietic cell transplantation (allo-HCT) remains heterogeneous. We retrospectively analyzed 216 patients undergoing a second allo-HCT for either relapse (56%) or graft failure (31%) between 2010 and 2017. Median age was 57.3 years (range 51–63). The same donor as for the first allo-HCT was chosen in 66 patients (31%) of whom 19 received an HLA-identical sibling donor, whereas a different donor was chosen for 116 patients (54%). Median follow-up was 40 months. Three-year overall survival (OS) and relapse-free survival (RFS) were 42% and 39%, respectively. Three-year non-relapse mortality (NRM) and relapse rates were 36% and 25%, respectively. Grade II-IV and III-IV acute GVHD occurred in 25% and 11% of patients, respectively, and the 3-year incidence of chronic GVHD was 33% including 14% for extensive grade. Graft-failure incidence at 1 year was 14%. In conclusion, our data suggest that a second allo-HCT is a potential option for patients failing first allo-HCT for MF albeit careful patient assessment is fundamental to identify individual patients who could benefit from this approach.
UR - https://www.scopus.com/pages/publications/85103629236
U2 - 10.1038/s41409-021-01271-4
DO - 10.1038/s41409-021-01271-4
M3 - Article
SN - 0268-3369
VL - 56
SP - 1944
EP - 1952
JO - Bone Marrow Transplantation
JF - Bone Marrow Transplantation
IS - 8
ER -