Effect of pre‐transplant JAK1/2 inhibitors and CD34 dose on transplant outcomes in myelofibrosis

Allogeneic hematopoeitic cell transplantation (allo‐HCT) is the only curative treatment for myelofibrosis (MF). We evaluate the impact of various factors on survival outcomes post‐transplant in MF. Data of 89 consecutive MF patients (primary 47%) who underwent allo‐HCT between 2005 and 2018 was eval...

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Published in:European journal of haematology 2021-11, Vol.107 (5), p.517-528
Main Authors: Cyriac, Sunu, Prem, Shruti, Salas, Maria Queralt, Chen, Shiyi, Al‐Shaibani, Zeyad, Lam, Wilson, Law, Arjun, Gupta, Vikas, Michelis, Fotios V., Kim, Dennis (Dong Hwan), Lipton, Jeffrey, Kumar, Rajat, Mattsson, Jonas, Viswabandya, Auro
Format: Article
Language:English
Subjects:
Adult
Aged
Allogeneic
Antigens, CD34 - immunology
CD34 antigen
CD34 count
Dose-Response Relationship, Immunologic
Female
Ferritin
Graft rejection
Graft vs Host Disease - prevention & control
Graft-versus-host reaction
Grafts
Hematopoietic cell transplantation
Hematopoietic Stem Cell Transplantation
Humans
JAK2 inhibitor
Janus kinase
Janus Kinase 1 - antagonists & inhibitors
Janus Kinase 2 - antagonists & inhibitors
Male
Middle Aged
Myelofibrosis
Patients
Primary Myelofibrosis - therapy
Protein Kinase Inhibitors - pharmacology
Survival Analysis
Transplantation
Transplantation, Homologous
Transplants & implants
Treatment Outcome
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Summary:Allogeneic hematopoeitic cell transplantation (allo‐HCT) is the only curative treatment for myelofibrosis (MF). We evaluate the impact of various factors on survival outcomes post‐transplant in MF. Data of 89 consecutive MF patients (primary 47%) who underwent allo‐HCT between 2005 and 2018 was evaluated. Fifty‐four percent patients had received JAK1/2 inhibitors (JAKi) pre‐HCT. The median CD34 count was 7.1x106 cells/kg. Graft failure was seen in 10% of the patients. Grade 3‐4 acute GVHD (aGVHD) and moderate/severe chronic graft versus host disease (cGVHD) occurred in 24% and 40% patients, respectively. Two‐year overall survival (OS) and relapse free survival (RFS) were 51% and 43%, respectively. Cumulative incidence of relapse (CIR) and non‐relapse mortality (NRM) at 2 years were 11% and 46%, respectively. Higher CD34 cell dose (≤5 × 106 cells/kg vs 5‐9 or ≥9 × 106 cells/kg) and lower pre‐HCT ferritin (
ISSN:0902-4441
1600-0609
DOI:10.1111/ejh.13689