Allogeneic Hematopoietic Stem Cell Transplantation for Post-essential Thrombocythemia and Post-polycythemia Vera Myelofibrosis

• Published in: Internal Medicine 2020/08/15, Vol.59(16), pp.1947-1956
• Main Authors: Murata, Makoto, Suzuki, Ritsuro, Nishida, Tetsuya, Shirane, Shuichi, Shimazu, Yutaka, Minami, Yosuke, Mori, Takehiko, Doki, Noriko, Kanda, Yoshinobu, Uchida, Naoyuki, Tanaka, Masatsugu, Ishikawa, Jun, Togitani, Kazuto, Fukuda, Takahiro, Ichinohe, Tatsuo, Atsuta, Yoshiko, Nagamura-Inoue, Tokiko, Kiyoi, Hitoshi
• Format: Article
• Language: English
• Subjects: Adult; Aged; Blood transfusion; Cord blood; Erythrocyte Transfusion; Erythrocytes; essential thrombocythemia; Female; Fetal Blood; Graft vs Host Disease - prevention & control; hematopoietic stem cell transplantation; Hematopoietic Stem Cell Transplantation - methods; Hematopoietic stem cells; Humans; Immunosuppressive Agents - therapeutic use; Internal medicine; Japan; Male; Middle Aged; Morpholines; Mortality; Myelofibrosis; Neutrophils; Original; Platelet Transfusion; Polycythemia; Polycythemia vera; Polycythemia Vera - complications; Primary Myelofibrosis - etiology; Primary Myelofibrosis - therapy; Prognosis; Retrospective Studies; Stem cell transplantation; Stem cells; Survival Rate; Thrombocythemia, Essential - complications; Tissue Donors; Transplantation, Homologous; Transplants & implants; Treatment Outcome; Umbilical cord
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.4375-19

Objective Little information is available about the outcome of allogeneic hematopoietic stem cell transplantation (HSCT) for patients with secondary myelofibrosis from essential thrombocythemia (ET) and polycythemia vera (PV). A nationwide retrospective study of the outcome of HSCT for post-ET and post-PV myelofibrosis was conducted in Japan. Patients and Methods Clinical data for patients with post-ET (n=29) and post-PV (n=9) myelofibrosis who had received first allogeneic HSCT were extracted from the Transplant Registry Unified Management Program, which is a registry of the outcomes of HSCT in Japan. Results Five patients died without neutrophil recovery within 60 days after transplantation. The incidence of neutrophil recovery was significantly lower in umbilical cord blood (UCB) transplantation than in related donor transplantation (40% vs. 92%, p=0.010). The 1-year non-relapse mortality for post-ET and post-PV myelofibrosis was 35% and 27%, respectively (p=0.972). No patient or transplantation characteristics were associated with non-relapse mortality. The 4-year overall survival for post-ET and post-PV myelofibrosis was 46% and 65%, respectively (p=0.362). A univariate analysis identified UCB transplantation (vs. related donor, p=0.017) and ≥10 times red blood cell transfusions before transplantation (vs.