Allogeneic stem cell transplantation for myeloproliferative neoplasm in blast phase

Chad Cherington, James L. Slack, Jose Leis, Roberta H. Adams, Craig B. Reeder, Joseph R. Mikhael, John Camoriano, Pierre Noel, Veena Fauble, Jeffrey Betcher, Meagan S. Higgins, Ginger Gillette-Kent, Lisa D. Tremblay, Mary E. Peterson, Jane J. Olsen, Raoul Tibes, Ruben A. Mesa

Research output: Contribution to journalArticle

33 Scopus citations

Abstract

The prognosis for patients with Philadelphia-negative myeloproliferative neoplasms (MPN) who evolve into acute myeloid leukemia (AML) or blast phase (MPN-BP) is extremely poor. Although allogeneic stem cell transplantation (allo-SCT) is considered potentially curative, very few patients have been reported who have undergone allo-SCT for MPN-BP; therefore the success rate remains unknown. In a retrospective review, we identified 13 patients with an MPN transformation to blast phase after a median 9 years (range 5 months to 30 years); 8 (median age 55) continued to allo-SCT within 6 months. Induction chemotherapy cleared blood/marrow blasts in 60% (6/10) (2 declined therapy, 1 had early death). At the time of allo-SCT, 5/8 patients were in complete remission (CR) of their leukemia or had returned to MPN chronic phase (CP), 2 had residual blood blasts and 1 was refractory with >5% marrow blasts. At follow-up (median 20.3 months), 6 patients are alive in CR of both their leukemia/MPN. All 5 patients in CR/CP at pre-allo-SCT remain alive in remission, while 2/3 with persistent blood/marrow blasts relapsed and expired. We conclude that MPN-BP can be cured by allo-SCT in a significant percentage of patients, but that adequate leukemic clearance prior to allo-SCT offers an optimal outcome.

Original languageEnglish (US)
Pages (from-to)1147-1151
Number of pages5
JournalLeukemia Research
Volume36
Issue number9
DOIs
StatePublished - Sep 1 2012

Keywords

  • Acute myeloid leukemia
  • Allogeneic stem cell transplantation
  • Essential thrombocythemia
  • Leukemic transformation
  • Myelofibrosis
  • Myeloproliferative neoplasm
  • Philadelphia negative myeloproliferative neoplasm
  • Polycythemia vera
  • Secondary
  • Secondary myelofibrosis

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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    Cherington, C., Slack, J. L., Leis, J., Adams, R. H., Reeder, C. B., Mikhael, J. R., Camoriano, J., Noel, P., Fauble, V., Betcher, J., Higgins, M. S., Gillette-Kent, G., Tremblay, L. D., Peterson, M. E., Olsen, J. J., Tibes, R., & Mesa, R. A. (2012). Allogeneic stem cell transplantation for myeloproliferative neoplasm in blast phase. Leukemia Research, 36(9), 1147-1151. https://doi.org/10.1016/j.leukres.2012.04.021