Allogeneic stem cell transplantation for myelofibrosis patients aged ≥65 years

作者：Giulia Daghia, Tatjana Zabelina, Gaby Zeck, Ute‐Marie von Pein, Maximilian Christopeit, Christine Wolschke, Francis Ayuk, Nicolaus Kröger · 发表于：European Journal Of Haematology · 年份：2019 · DOI：10.1111/ejh.13294 · 被引用次数：17 · 研究领域：Myeloproliferative Neoplasms: Diagnosis and Treatment、Multiple Myeloma Research and Treatments、Chronic Myeloid Leukemia Treatments

INTRODUCTION: Myelofibrosis (MF) is a disease of elderly with median age of 65 years at diagnosis. Allogeneic stem cell transplantation (ASCT) currently is the only potentially curative option, although associated with treatment-related morbidity and mortality. Development of reduced intensity conditioning (RIC) regimens enabled transplant to be performed successfully in older patients. OBJECTIVES AND METHODS: To evaluate outcome of transplantation among elderly patients (≥65 years), we conducted retrospective analysis of results in 45 patients transplanted between 2002 and 2018 at the University Medical Center Hamburg. Median age at ASCT was 67 years (r: 65-74). The majority of patients (n = 43) received busulfan plus fludarabine RIC regimen and were classified as DIPSS intermediate-2 or high risk at time of transplantation. RESULTS: After a median follow-up of 4 years, 6-year estimated progression-free survival and overall survival were 60% and 64%, respectively. Cumulative incidence of non-relapse mortality was 21% at 1 year. Cumulative incidence of relapse at 6 years was 10%. Patients with Sorror score 3 or less had a significant better survival (73% vs 25%, P = .009). CONCLUSION: Reduced intensity conditioning regimen followed by ASCT in older patients with myelofibrosis is a curative treatment option. Outcome is more favorable in patients with no or minimal comorbidities.