Stem cell transplantation for myelofibrosis: a report from two Canadian centers.

We describe the course of 25 patients with myelofibrosis (MF) due to agnogenic myeloid metaplasia (n=19) or essential thrombocytosis (n=6) who underwent allogeneic stem cell transplantation (SCT) at one of two Canadian centers. The median age at transplantation was 48.7 (IQR 45.9-50.4) years and transplantation was carried out at a median of 10.7 (IQR 5.67-26.5) months after diagnosis. Granulocyte engraftment (absolute neutrophil count >0.5 x 109/l) occurred at a median of 20 days after transplantation for splenectomized patients, compared with 27.5 days for nonsplenectomized individuals (P=0.03). Increased risk of grade II-IV acute graft-versus-host disease (P=0.04) was noted in patients transplanted after splenectomy. Patients with MF received 0.264+/-0.189 U of packed red blood cells per day over the first 180 days after transplantation, and remained dependent on red blood cell transfusions for a median of 123 (IQR 48-205) days. Complete remission of MF was documented in 33% of evaluable patients. The 1 year cumulative nonrelapse mortality was 48.3%. Median survival for this group of patients was 393 (IQR 109-1014+) days, with a projected 2-year overall survival of 41%. We conclude that allogeneic SCT offers a reasonable chance for prolonged survival in patients with advanced MF, but this occurs at the cost of considerable toxicity and nonrelapse mortality.
AuthorsA Daly, K Song, T Nevill, S Nantel, C Toze, D Hogge, D Forrest, J Lavoie, H Sutherland, J Shepherd, W Hasegawa, J Lipton, H Messner, T Kiss
JournalBone marrow transplantation (Bone Marrow Transplant) Vol. 32 Issue 1 Pg. 35-40 (Jul 2003) ISSN: 0268-3369 [Print] England
PMID12815476 (Publication Type: Journal Article)
  • Erythrocyte Transfusion
  • Female
  • Follow-Up Studies
  • Graft Survival
  • Graft vs Host Disease (etiology)
  • Hematopoietic Stem Cell Transplantation (adverse effects, methods, mortality)
  • Hepatic Veno-Occlusive Disease (etiology)
  • Humans
  • Male
  • Middle Aged
  • Primary Myelofibrosis (complications, etiology, mortality, therapy)
  • Splenectomy
  • Survival Analysis
  • Thrombocytosis (complications)
  • Transplantation, Homologous

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