A simple prognostic system in patients with myelofibrosis undergoing allogeneic stem cell transplantation: a CIBMTR/EBMT analysis.
Publication/Presentation Date
8-8-2023
Abstract
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/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.
Volume
7
Issue
15
First Page
3993
Last Page
4002
ISSN
2473-9537
Published In/Presented At
Tamari, R., McLornan, D. P., Ahn, K. W., Estrada-Merly, N., Hernández-Boluda, J. C., Giralt, S., Palmer, J., Gale, R. P., DeFilipp, Z., Marks, D. I., van der Poel, M., Verdonck, L. F., Battiwalla, M., Diaz, M. A., Gupta, V., Ali, H., Litzow, M. R., Lazarus, H. M., Gergis, U., Bashey, A., … Saber, W. (2023). A simple prognostic system in patients with myelofibrosis undergoing allogeneic stem cell transplantation: a CIBMTR/EBMT analysis. Blood advances, 7(15), 3993–4002. https://doi.org/10.1182/bloodadvances.2023009886
Disciplines
Medicine and Health Sciences
PubMedID
37134306
Department(s)
Department of Medicine, Lehigh Valley Topper Cancer Institute
Document Type
Article