Allogeneic hematopoietic stem cell transplantation should be considered for eligible patients with primary myelofibrosis, according to a study by Turkish researchers published in the Balkan Medical Journal. This is based on the fact that nontransplant recipients have a poor prognosis, and there are no nontransplant curative approaches for the disease.
To explore overall outcomes in patients with myelofibrosis who are treated with allogeneic hematopoietic stem cell transplantation, the team, which was led by Muhit Ozcan, MD, from Ankara University in Turkey, retrospectively analyzed 26 patients with primary myelofibrosis who underwent the procedure at their center from January 2002 to January 2022.
Read more about the treatment of myelofibrosis
The team reported that neutrophil and platelet engraftment was achieved in the majority of patients (88.5%) at a median follow-up of 21.2 months. Neutrophil engraftment occurred at a median of 16 days, and platelet engraftment occurred at a median of 20 days. One patient had primary graft failure.
Acute graft-versus-host disease occurred in half of the patients with engrafted allografts. Of these (31.8%) were in grade 3 or 4. A little more than a third (36.4%) of patients had chronic graft-versus-host disease.
Four patients relapsed after a median of 5.5 months, and 3 had donor lymphocyte infusion.
The 3-year overall survival rate for all patients was 46.2%. The median overall survival was not reached in the myeloablative conditioning group. In the reduced-intensity conditioning group, however, it was 11.9 months.
In mismatched unrelated graft recipients, the median overall survival was 0.73 months, while in matched sibling donors, it was 12 months. It was not reached in matched unrelated graft recipients.
The progression-free survival rate of patients who survived more than 100 days was 74.7%. The JAK-2 status, the graft source, the conditioning regimen, or the dynamic international prognostic scoring system had no significant effect on the progression-free survival rate.
Cengiz Seval G, Civriz Bozdag S, Toprak SK, et al. Allogeneic hematopoietic stem cell transplantation for primary myelofibrosis: a 20-year experience in a single center. Balkan Med J. Published online March 24, 2023. doi:10.4274/balkanmedj.galenos.2023.2022-2-32