Reduced-Intensity Hematopoietic Cell Transplantation for Patients with Primary Myelofibrosis: A Cohort Analysis from the Center for International Blood and Marrow Transplant Research

Vikas Gupta, Adriana K. Malone, Parameswaran N. Hari, Kwang Woo Ahn, Zhen Huan Hu, Robert Peter Gale, Karen K. Ballen, Mehdi Hamadani, Eduardo Olavarria, Aaron T. Gerds, Edmund K. Waller, Luciano J. Costa, Joseph H. Antin, Rammurti T. Kamble, Koen M. van Besien, Bipin N. Savani, Harry C. Schouten, Jeffrey Szer, Jean Yves Cahn, Marcos J. de LimaBaldeep Wirk, Mahmoud D. Aljurf, Uday Popat, Nelli Bejanyan, Mark R Litzow, Maxim Norkin, Ian D. Lewis, Gregory A. Hale, Ann E. Woolfrey, Alan M. Miller, Celalettin Ustun, Madan H. Jagasia, Michael Lill, Richard T. Maziarz, Jorge Cortes, Matt E. Kalaycio, Wael Saber

Research output: Contribution to journalArticle

58 Citations (Scopus)

Abstract

We evaluated outcomes and associated prognostic factors in 233 patients undergoing allogeneic hematopoietic cell transplantation (HCT) for primary myelofibrosis (MF) using reduced-intensity conditioning (RIC). The median age at RIC HCT was 55 yr. Donors were a matched sibling donor (MSD) in 34% of RIC HCTs, an HLA well-matched unrelated donor (URD) in 45%, and a partially matched/mismatched URD in 21%. Risk stratification according to the Dynamic International Prognostic Scoring System (DIPSS) was 12% low, 49% intermediate-1, 37% intermediate-2, and 1% high. The probability of survival at 5 yr was 47% (95% confidence interval [CI], 40% to 53%). In a multivariate analysis, donor type was the sole independent factor associated with survival. Adjusted probabilities of survival at 5-yr were 56% (95% CI, 44% to 67%) for MSD, 48% (95% CI, 37% to 58%) for well-matched URD, and 34% (95% CI, 21% to 47%) for partially matched/mismatched URD (P=002). The relative risk (RR) for NRM was 3.92 (P= .006) for well-matched URD and 9.37 (P < .0001) for partially matched/mismatched URD. Trends toward increased NRM (RR, 1.7; P= .07) and inferior survival (RR, 1.37; P= .10) were observed in DIPSS intermediate-2/high-risk patients compared with DIPSS low/intermediate-1 risk patients. Our data indicate that RIC HCT is a potentially curative option for patients with MF, and that donor type is the most important factor influencing survival in these patients.

Original languageEnglish (US)
Pages (from-to)89-97
Number of pages9
JournalBiology of Blood and Marrow Transplantation
Volume20
Issue number1
DOIs
StatePublished - Jan 2014

Fingerprint

Unrelated Donors
Primary Myelofibrosis
Cell Transplantation
Cohort Studies
Bone Marrow
Transplants
Tissue Donors
Survival
Research
Confidence Intervals
Siblings
Multivariate Analysis
Conditioning (Psychology)

Keywords

  • Allogeneic transplantation
  • Myelofibrosis
  • Prognosis
  • Reduced intensity

ASJC Scopus subject areas

  • Transplantation
  • Hematology

Cite this

Reduced-Intensity Hematopoietic Cell Transplantation for Patients with Primary Myelofibrosis : A Cohort Analysis from the Center for International Blood and Marrow Transplant Research. / Gupta, Vikas; Malone, Adriana K.; Hari, Parameswaran N.; Ahn, Kwang Woo; Hu, Zhen Huan; Gale, Robert Peter; Ballen, Karen K.; Hamadani, Mehdi; Olavarria, Eduardo; Gerds, Aaron T.; Waller, Edmund K.; Costa, Luciano J.; Antin, Joseph H.; Kamble, Rammurti T.; van Besien, Koen M.; Savani, Bipin N.; Schouten, Harry C.; Szer, Jeffrey; Cahn, Jean Yves; de Lima, Marcos J.; Wirk, Baldeep; Aljurf, Mahmoud D.; Popat, Uday; Bejanyan, Nelli; Litzow, Mark R; Norkin, Maxim; Lewis, Ian D.; Hale, Gregory A.; Woolfrey, Ann E.; Miller, Alan M.; Ustun, Celalettin; Jagasia, Madan H.; Lill, Michael; Maziarz, Richard T.; Cortes, Jorge; Kalaycio, Matt E.; Saber, Wael.

In: Biology of Blood and Marrow Transplantation, Vol. 20, No. 1, 01.2014, p. 89-97.

Research output: Contribution to journalArticle

Gupta, V, Malone, AK, Hari, PN, Ahn, KW, Hu, ZH, Gale, RP, Ballen, KK, Hamadani, M, Olavarria, E, Gerds, AT, Waller, EK, Costa, LJ, Antin, JH, Kamble, RT, van Besien, KM, Savani, BN, Schouten, HC, Szer, J, Cahn, JY, de Lima, MJ, Wirk, B, Aljurf, MD, Popat, U, Bejanyan, N, Litzow, MR, Norkin, M, Lewis, ID, Hale, GA, Woolfrey, AE, Miller, AM, Ustun, C, Jagasia, MH, Lill, M, Maziarz, RT, Cortes, J, Kalaycio, ME & Saber, W 2014, 'Reduced-Intensity Hematopoietic Cell Transplantation for Patients with Primary Myelofibrosis: A Cohort Analysis from the Center for International Blood and Marrow Transplant Research', Biology of Blood and Marrow Transplantation, vol. 20, no. 1, pp. 89-97. https://doi.org/10.1016/j.bbmt.2013.10.018
Gupta, Vikas ; Malone, Adriana K. ; Hari, Parameswaran N. ; Ahn, Kwang Woo ; Hu, Zhen Huan ; Gale, Robert Peter ; Ballen, Karen K. ; Hamadani, Mehdi ; Olavarria, Eduardo ; Gerds, Aaron T. ; Waller, Edmund K. ; Costa, Luciano J. ; Antin, Joseph H. ; Kamble, Rammurti T. ; van Besien, Koen M. ; Savani, Bipin N. ; Schouten, Harry C. ; Szer, Jeffrey ; Cahn, Jean Yves ; de Lima, Marcos J. ; Wirk, Baldeep ; Aljurf, Mahmoud D. ; Popat, Uday ; Bejanyan, Nelli ; Litzow, Mark R ; Norkin, Maxim ; Lewis, Ian D. ; Hale, Gregory A. ; Woolfrey, Ann E. ; Miller, Alan M. ; Ustun, Celalettin ; Jagasia, Madan H. ; Lill, Michael ; Maziarz, Richard T. ; Cortes, Jorge ; Kalaycio, Matt E. ; Saber, Wael. / Reduced-Intensity Hematopoietic Cell Transplantation for Patients with Primary Myelofibrosis : A Cohort Analysis from the Center for International Blood and Marrow Transplant Research. In: Biology of Blood and Marrow Transplantation. 2014 ; Vol. 20, No. 1. pp. 89-97.
@article{230113d99ecf4dcb8a1dd19fc85f7067,
title = "Reduced-Intensity Hematopoietic Cell Transplantation for Patients with Primary Myelofibrosis: A Cohort Analysis from the Center for International Blood and Marrow Transplant Research",
abstract = "We evaluated outcomes and associated prognostic factors in 233 patients undergoing allogeneic hematopoietic cell transplantation (HCT) for primary myelofibrosis (MF) using reduced-intensity conditioning (RIC). The median age at RIC HCT was 55 yr. Donors were a matched sibling donor (MSD) in 34{\%} of RIC HCTs, an HLA well-matched unrelated donor (URD) in 45{\%}, and a partially matched/mismatched URD in 21{\%}. Risk stratification according to the Dynamic International Prognostic Scoring System (DIPSS) was 12{\%} low, 49{\%} intermediate-1, 37{\%} intermediate-2, and 1{\%} high. The probability of survival at 5 yr was 47{\%} (95{\%} confidence interval [CI], 40{\%} to 53{\%}). In a multivariate analysis, donor type was the sole independent factor associated with survival. Adjusted probabilities of survival at 5-yr were 56{\%} (95{\%} CI, 44{\%} to 67{\%}) for MSD, 48{\%} (95{\%} CI, 37{\%} to 58{\%}) for well-matched URD, and 34{\%} (95{\%} CI, 21{\%} to 47{\%}) for partially matched/mismatched URD (P=002). The relative risk (RR) for NRM was 3.92 (P= .006) for well-matched URD and 9.37 (P < .0001) for partially matched/mismatched URD. Trends toward increased NRM (RR, 1.7; P= .07) and inferior survival (RR, 1.37; P= .10) were observed in DIPSS intermediate-2/high-risk patients compared with DIPSS low/intermediate-1 risk patients. Our data indicate that RIC HCT is a potentially curative option for patients with MF, and that donor type is the most important factor influencing survival in these patients.",
keywords = "Allogeneic transplantation, Myelofibrosis, Prognosis, Reduced intensity",
author = "Vikas Gupta and Malone, {Adriana K.} and Hari, {Parameswaran N.} and Ahn, {Kwang Woo} and Hu, {Zhen Huan} and Gale, {Robert Peter} and Ballen, {Karen K.} and Mehdi Hamadani and Eduardo Olavarria and Gerds, {Aaron T.} and Waller, {Edmund K.} and Costa, {Luciano J.} and Antin, {Joseph H.} and Kamble, {Rammurti T.} and {van Besien}, {Koen M.} and Savani, {Bipin N.} and Schouten, {Harry C.} and Jeffrey Szer and Cahn, {Jean Yves} and {de Lima}, {Marcos J.} and Baldeep Wirk and Aljurf, {Mahmoud D.} and Uday Popat and Nelli Bejanyan and Litzow, {Mark R} and Maxim Norkin and Lewis, {Ian D.} and Hale, {Gregory A.} and Woolfrey, {Ann E.} and Miller, {Alan M.} and Celalettin Ustun and Jagasia, {Madan H.} and Michael Lill and Maziarz, {Richard T.} and Jorge Cortes and Kalaycio, {Matt E.} and Wael Saber",
year = "2014",
month = "1",
doi = "10.1016/j.bbmt.2013.10.018",
language = "English (US)",
volume = "20",
pages = "89--97",
journal = "Biology of Blood and Marrow Transplantation",
issn = "1083-8791",
publisher = "Elsevier Inc.",
number = "1",

}

TY - JOUR

T1 - Reduced-Intensity Hematopoietic Cell Transplantation for Patients with Primary Myelofibrosis

T2 - A Cohort Analysis from the Center for International Blood and Marrow Transplant Research

AU - Gupta, Vikas

AU - Malone, Adriana K.

AU - Hari, Parameswaran N.

AU - Ahn, Kwang Woo

AU - Hu, Zhen Huan

AU - Gale, Robert Peter

AU - Ballen, Karen K.

AU - Hamadani, Mehdi

AU - Olavarria, Eduardo

AU - Gerds, Aaron T.

AU - Waller, Edmund K.

AU - Costa, Luciano J.

AU - Antin, Joseph H.

AU - Kamble, Rammurti T.

AU - van Besien, Koen M.

AU - Savani, Bipin N.

AU - Schouten, Harry C.

AU - Szer, Jeffrey

AU - Cahn, Jean Yves

AU - de Lima, Marcos J.

AU - Wirk, Baldeep

AU - Aljurf, Mahmoud D.

AU - Popat, Uday

AU - Bejanyan, Nelli

AU - Litzow, Mark R

AU - Norkin, Maxim

AU - Lewis, Ian D.

AU - Hale, Gregory A.

AU - Woolfrey, Ann E.

AU - Miller, Alan M.

AU - Ustun, Celalettin

AU - Jagasia, Madan H.

AU - Lill, Michael

AU - Maziarz, Richard T.

AU - Cortes, Jorge

AU - Kalaycio, Matt E.

AU - Saber, Wael

PY - 2014/1

Y1 - 2014/1

N2 - We evaluated outcomes and associated prognostic factors in 233 patients undergoing allogeneic hematopoietic cell transplantation (HCT) for primary myelofibrosis (MF) using reduced-intensity conditioning (RIC). The median age at RIC HCT was 55 yr. Donors were a matched sibling donor (MSD) in 34% of RIC HCTs, an HLA well-matched unrelated donor (URD) in 45%, and a partially matched/mismatched URD in 21%. Risk stratification according to the Dynamic International Prognostic Scoring System (DIPSS) was 12% low, 49% intermediate-1, 37% intermediate-2, and 1% high. The probability of survival at 5 yr was 47% (95% confidence interval [CI], 40% to 53%). In a multivariate analysis, donor type was the sole independent factor associated with survival. Adjusted probabilities of survival at 5-yr were 56% (95% CI, 44% to 67%) for MSD, 48% (95% CI, 37% to 58%) for well-matched URD, and 34% (95% CI, 21% to 47%) for partially matched/mismatched URD (P=002). The relative risk (RR) for NRM was 3.92 (P= .006) for well-matched URD and 9.37 (P < .0001) for partially matched/mismatched URD. Trends toward increased NRM (RR, 1.7; P= .07) and inferior survival (RR, 1.37; P= .10) were observed in DIPSS intermediate-2/high-risk patients compared with DIPSS low/intermediate-1 risk patients. Our data indicate that RIC HCT is a potentially curative option for patients with MF, and that donor type is the most important factor influencing survival in these patients.

AB - We evaluated outcomes and associated prognostic factors in 233 patients undergoing allogeneic hematopoietic cell transplantation (HCT) for primary myelofibrosis (MF) using reduced-intensity conditioning (RIC). The median age at RIC HCT was 55 yr. Donors were a matched sibling donor (MSD) in 34% of RIC HCTs, an HLA well-matched unrelated donor (URD) in 45%, and a partially matched/mismatched URD in 21%. Risk stratification according to the Dynamic International Prognostic Scoring System (DIPSS) was 12% low, 49% intermediate-1, 37% intermediate-2, and 1% high. The probability of survival at 5 yr was 47% (95% confidence interval [CI], 40% to 53%). In a multivariate analysis, donor type was the sole independent factor associated with survival. Adjusted probabilities of survival at 5-yr were 56% (95% CI, 44% to 67%) for MSD, 48% (95% CI, 37% to 58%) for well-matched URD, and 34% (95% CI, 21% to 47%) for partially matched/mismatched URD (P=002). The relative risk (RR) for NRM was 3.92 (P= .006) for well-matched URD and 9.37 (P < .0001) for partially matched/mismatched URD. Trends toward increased NRM (RR, 1.7; P= .07) and inferior survival (RR, 1.37; P= .10) were observed in DIPSS intermediate-2/high-risk patients compared with DIPSS low/intermediate-1 risk patients. Our data indicate that RIC HCT is a potentially curative option for patients with MF, and that donor type is the most important factor influencing survival in these patients.

KW - Allogeneic transplantation

KW - Myelofibrosis

KW - Prognosis

KW - Reduced intensity

UR - http://www.scopus.com/inward/record.url?scp=84890911661&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84890911661&partnerID=8YFLogxK

U2 - 10.1016/j.bbmt.2013.10.018

DO - 10.1016/j.bbmt.2013.10.018

M3 - Article

C2 - 24161923

AN - SCOPUS:84890911661

VL - 20

SP - 89

EP - 97

JO - Biology of Blood and Marrow Transplantation

JF - Biology of Blood and Marrow Transplantation

SN - 1083-8791

IS - 1

ER -