A simple prognostic system in patients with myelofibrosis undergoing allogeneic stem cell transplantation: a CIBMTR/EBMT analysis
Por:
Tamari R, McLornan D, Ahn K, Estrada-Merly N, Hernandez-Boluda J, Giralt S, Palmer J, Gale R, DeFilipp Z, Marks D, van der Poel M, Verdonck L, Battiwalla M, Diaz M, Gupta V, Ali H, Litzow M, Lazarus H, Gergis U, Bashey A, Liesveld J, Hashmi S, Pu J, Beitinjaneh A, Bredeson C, Rizzieri D, Savani B, Abid M, Ganguly S, Agrawal V, Ulrike V, Wirk B, Jain T, Cutler C, Aljurf M, Kindwall-Keller T, Kharfan-Dabaja M, Hildebrandt G, Pawarode A, Solh M, Yared J, Grunwald M, Nathan S, Nishihori T, Seo S, Scott B, Nakamura R, Oran B, Czerw T, Yakoub-Agha I, Saber W
Publicada:
8 ago 2023
Ahead of Print:
1 ago 2023
Resumen:
To develop a prognostic model for patients undergoing allogeneic hematopoietic cell transplantation (allo-HCT) for myelofibrosis (MF), we examined the data of 623 patients undergoing allo-HCT between 2000 and 2016 in the United States (the Center for International Blood and Marrow Transplant Research [CIBMTR] cohort). A Cox multivariable model was used to identify factors prognostic of mortality. A weighted score using these factors was assigned to patients who received transplantation in Europe (the European Bone Marrow Transplant [EBMT] cohort; n = 623). Patient age >50 years (hazard ratio [HR], 1.39; 95% confidence interval [CI], 0.98-1.96), and HLA-matched unrelated donor (HR, 1.29; 95% CI, 0.98-1.7) were associated with an increased hazard of death and were assigned 1 point. Hemoglobin levels <100 g/L at time of transplantation (HR, 1.63; 95% CI, 1.2-2.19) and a mismatched unrelated donor (HR, 1.78; 95% CI, 1.25-2.52) were assigned 2 points. The 3-year overall survival (OS) in patients with a low (1-2 points), intermediate (3-4 points), and high score (5 points) were 69% (95% CI, 61-76), 51% (95% CI, 46-56.4), and 34% (95% CI, 21-49), respectively (P < .001). Increasing score was predictive of increased transplant-related mortality (TRM; P = .0017) but not of relapse (P = .12). The derived score was predictive of OS (P < .001) and TRM (P = .002) but not of relapse (P = .17) in the EBMT cohort as well. The proposed system was prognostic of survival in 2 large cohorts, CIBMTR and EBMT, and can easily be applied by clinicians consulting patients with MF about the transplantation outcomes.
Filiaciones:
Hernandez-Boluda J:
Hospital Clínico Valencia, Valencia, Spain
Memorial Sloan Kettering, New York, New York, United States.; University College Hospital, London, United Kingdom.; Medical College of Wisconsin, Milwaukee, Wisconsin, United States.; CIBMTR, Milwaukee, Wisconsin, United States.; Hospital Clinico Valencia, Valencia, Spain.; Memorial Sloan Kettering Cancer Center, New York, New York, United States.; Mayo Clinic, Phoenix, Arizona, United States.; Centre for Haematology Research, Department of Immunology and Inflammation, Imperial College London, L
Green Published, gold
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