• Elsa Lestang, Pierre Peterlin, Yannick Le Bris, Viviane Dubruille, Jacques Delaunay, Catherine Godon, Olivier Theisen, Nicolas Blin, Beatrice Mahe, Thomas Gastinne, Alice Garnier, Cyrille Touzeau, Maud Voldoire, Marie C Bene, Le GouillStevenSHematology Department, CHU Hotel-Dieu, Nantes, France., Noel Milpied, Mohamad Mohty, Philippe Moreau, Thierry Guillaume, and Patrice Chevallier.
• Hematology Department, CHU Hotel-Dieu, Nantes, France.
• Eur. J. Haematol. 2017 Jul 1; 99 (1): 60-69.

ObjectiveThe role of allogenic stem cell transplantation (ASCT) is still debated in myelofibrosis (MF).MethodsA retrospective analyzed was performed to compare the outcome of 71 patients with intermediate-2 or high-risk Dynamic International Prognosis Scoring System+ (DIPSS+) primary (PMF) or secondary (SMF) myelofibrosis with an indication of ASCT as they ultimately underwent the procedure (n=34) or not (n=37).ResultsFive-year overall survival (OS) was not statistically different between both groups (allograft: 52% vs no allograft: 34%, P=.12). However, progression to myelodysplastic syndrome or acute myeloid leukemia at 5 years was significantly lower in transplanted patients (14% vs 50%, P=.01). In univariate analysis, 5-year OS was significantly higher for transplanted vs non-transplanted patients with unfavorable karyotype (75% vs 0%, P=.001), SMF (71% vs 20%, P=.001) or high DIPSS+ score (46% vs 15%, P=.03). There was also a trend for better 5-year OS in allografted patients with high JAK2V617F burden (>65%) (75% vs 8%, P=.07). Interestingly, the survival of patients who did not proceed to ASCT was dramatically increased by the use of ruxolitinib.ConclusionsNot all intermediate-2/high-risk DIPSS+ MF patients benefit from ASCT, especially since the introduction of JAK2 inhibitors.© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

30 keywords...

hide…