Rapid regression of bone marrow fibrosis after dose-reduced allogeneic stem cell transplantation in patients with primary myelofibrosis.

Abstract

OBJECTIVE:

To investigate the effect of a busulfan/fludarabine-based reduced intensity conditioning followed by allogeneic stem cell transplantation on regression of bone marrow fibrosis in patients with myelofibrosis.

METHODS:

Twenty-four patients (male, n = 16; female, n = 8) with a median age of 52 years (range, 32-63 years) were included. Six patients were transplanted from human leukocyte antigen-identical siblings and 18 patients from matched unrelated donors. Diagnosis was primary myelofibrosis in 18 patients and secondary myelofibrosis in 6 patients; in 4 of them, primary myelofibrosis evolved from polycythemia vera, and in 2 of them from essential thrombocythemia. Using the European Consensus on grading bone marrow fibrosis, all patients had advanced marrow fibrosis MF-2 (n = 13) or MF-3 (n = 11) before allografting According to the Lille Risk Factor Scoring System, patients were classified as low risk (n = 5), intermediate risk (n = 16), or high risk (n = 3).

RESULTS:

After stem cell transplantation, a complete (MF-0) or nearly complete (MF-1) regression of bone marrow fibrosis was seen in 59% at day +100, in 90% at day +180, and in 100% at day +360. No correlation between occurrence of acute graft-vs-host disease and fibrosis regression on day +180 was observed.

CONCLUSION:

This study shows that allogeneic stem cell transplantation after reduced-intensity conditioning resulted in rapid regression of bone-marrow fibrosis.

• Authors: Nicolaus Kröger, Jürgen Thiele, Axel Zander, Rainer Schwerdtfeger, Guido Kobbe, Martin Bornhäuser, Wolfgang Bethge, Jörg Schubert, Theo de Witte, Hans Michael Kvasnicka, MDS-Subcommittee of the Chronic Leukaemia Working Party of the European Group for Blood and Marrow Transplantation
• Journal: Experimental hematology (Exp Hematol) Vol. 35 Issue 11 Pg. 1719-22 (Nov 2007) ISSN: 0301-472X [Print] Netherlands
• PMID: 17976523 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Vidarabine
• Busulfan
• fludarabine

Topics

• Adult
• Bone Marrow Examination
• Busulfan (administration & dosage)
• Female
• Graft vs Host Disease
• Hematopoietic Stem Cell Transplantation (methods)
• Humans
• Kinetics
• Male
• Middle Aged
• Primary Myelofibrosis (therapy)
• Remission Induction (methods)
• Severity of Illness Index
• Transplantation Conditioning (methods)
• Transplantation, Homologous
• Treatment Outcome
• Vidarabine (administration & dosage, analogs & derivatives)