Allogeneic Hematopoietic Stem Cell Transplantation for Primary Myelofibrosis: A 20-year Experience in a Single Center
Background: Allogeneic hematopoietic stem cell transplantation is a well-established approach for patients diagnosed with primary myelofibrosis and remains the only potentially curative treatment. Aims: To present the overall outcome of patients with myelofibrosis treated with allogeneic hematopoie...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Galenos Publishing House
2023-05-01
|
| Series: | Balkan Medical Journal |
| Online Access: | http://www.balkanmedicaljournal.org/text.php?lang=en&id=2482 |
| _version_ | 1797828784829759488 |
|---|---|
| author | Guldane Cengiz Seval Sinem Civriz Bozdag Selami Kocak Toprak Meltem Kurt Yuksel Pervin Topcuoglu Onder Arslan Taner Demirer Gunhan Gurman Meral Beksac Osman Ilhan Muhit Ozcan |
| author_facet | Guldane Cengiz Seval Sinem Civriz Bozdag Selami Kocak Toprak Meltem Kurt Yuksel Pervin Topcuoglu Onder Arslan Taner Demirer Gunhan Gurman Meral Beksac Osman Ilhan Muhit Ozcan |
| author_sort | Guldane Cengiz Seval |
| collection | DOAJ |
| description | Background: Allogeneic hematopoietic stem cell transplantation is a well-established approach for patients diagnosed with primary myelofibrosis and remains the only potentially curative treatment.
Aims: To present the overall outcome of patients with myelofibrosis treated with allogeneic hematopoietic stem cell transplantation.
Study Design: A retrospective cross-sectional study
Methods: This study is a retrospective analysis of 26 consecutive patients with primary myelofibrosis who underwent transplantation at our center between January 2002 and January 2022. Disease and transplant variables contributing to outcomes were analyzed.
Results: The median age at the time of transplantation was 52.5 (range, 32-63) years and the median time from diagnosis to allogeneic hematopoietic stem cell transplantation was 25 (range, 3.1-156.8) months. Myeloablative conditioning and reduced-intensity conditioning regimens were used in 8 (30.8%) and 18 (69.2%) transplantations, respectively. Neutrophil and platelet engraftment was achieved in 23 patients at a median follow-up of 21.2 months (range, 12 days to 234.8 months). Primary graft failure occurred in 1 of 23 patients (4.3%). Neutrophil and platelet engraftment occurred at a median of 16 (range, 12-39) days and 20 (range, 11-78) days, respectively. Acute graft-versus-host disease was seen in 11 of 22 patients engrafted allografts, of which 7 (31.8%) were grade 3-4 acute graft-versus-host disease. Eight patients (36.4%) developed chronic graft-versus-host disease, and three cases were extensive. Four patients (19%) relapsed after a median of 5.5 months, and three patients received donor lymphocyte infusion. The 3-year overall survival rate of the entire study population was 46.2%. The median overall survival was not reached in the myeloablative conditioning group; however, it was 11.9 months in the reduced-intensity conditioning group (p =0.3). According to the donor graft source, the median overall survival was 0.73 months in mismatched unrelated graft recipients, 12 months in matched sibling donors, and not reached in matched unrelated graft recipients (p = 0.03). The 3-year progression-free survival rate of patients who survived > 100 days was 74.7%. The effect of JAK-2 status, graft source, conditioning regimen or dynamic international prognostic scoring system on progression-free survival was not statistically significant.
Conclusion: Given the poor prognosis of non-transplant recipients and the lack of non-transplant curative approaches, our results support the consideration of allogeneic hematopoietic stem cell transplantation for eligible patients with primary myelofibrosis. |
| first_indexed | 2024-04-09T13:09:57Z |
| format | Article |
| id | doaj.art-31bb8173591949c6905e9d512718c6ce |
| institution | Directory Open Access Journal |
| issn | 2146-3123 2146-3131 |
| language | English |
| last_indexed | 2024-04-09T13:09:57Z |
| publishDate | 2023-05-01 |
| publisher | Galenos Publishing House |
| record_format | Article |
| series | Balkan Medical Journal |
| spelling | doaj.art-31bb8173591949c6905e9d512718c6ce2023-05-12T08:34:37ZengGalenos Publishing HouseBalkan Medical Journal2146-31232146-31312023-05-0140319720410.4274/balkanmedj.galenos.2023.2022-2-32Allogeneic Hematopoietic Stem Cell Transplantation for Primary Myelofibrosis: A 20-year Experience in a Single CenterGuldane Cengiz Seval0https://orcid.org/0000-0001-9433-2054Sinem Civriz Bozdag1https://orcid.org/0000-0001-8359-7794Selami Kocak Toprak2https://orcid.org/0000-0001-7717-5827Meltem Kurt Yuksel3https://orcid.org/0000-0003-0369-299XPervin Topcuoglu4https://orcid.org/0000-0002-4834-3585Onder Arslan5https://orcid.org/0000-0002-1883-1414Taner Demirer6https://orcid.org/0000-0002-2214-5927Gunhan Gurman7https://orcid.org/0000-0002-1263-8947Meral Beksac8https://orcid.org/0000-0003-1797-8657Osman Ilhan9https://orcid.org/0000-0003-1665-372XMuhit Ozcan10https://orcid.org/0000-0002-1326-1918Department of Hematology, Ankara University Faculty of Medicine, Ankara, TurkeyDepartment of Hematology, Ankara University Faculty of Medicine, Ankara, TurkeyDepartment of Hematology, Ankara University Faculty of Medicine, Ankara, TurkeyDepartment of Hematology, Ankara University Faculty of Medicine, Ankara, TurkeyDepartment of Hematology, Ankara University Faculty of Medicine, Ankara, TurkeyDepartment of Hematology, Ankara University Faculty of Medicine, Ankara, TurkeyDepartment of Hematology, Ankara University Faculty of Medicine, Ankara, TurkeyDepartment of Hematology, Ankara University Faculty of Medicine, Ankara, TurkeyDepartment of Hematology, Ankara University Faculty of Medicine, Ankara, TurkeyDepartment of Hematology, Ankara University Faculty of Medicine, Ankara, TurkeyDepartment of Hematology, Ankara University Faculty of Medicine, Ankara, TurkeyBackground: Allogeneic hematopoietic stem cell transplantation is a well-established approach for patients diagnosed with primary myelofibrosis and remains the only potentially curative treatment. Aims: To present the overall outcome of patients with myelofibrosis treated with allogeneic hematopoietic stem cell transplantation. Study Design: A retrospective cross-sectional study Methods: This study is a retrospective analysis of 26 consecutive patients with primary myelofibrosis who underwent transplantation at our center between January 2002 and January 2022. Disease and transplant variables contributing to outcomes were analyzed. Results: The median age at the time of transplantation was 52.5 (range, 32-63) years and the median time from diagnosis to allogeneic hematopoietic stem cell transplantation was 25 (range, 3.1-156.8) months. Myeloablative conditioning and reduced-intensity conditioning regimens were used in 8 (30.8%) and 18 (69.2%) transplantations, respectively. Neutrophil and platelet engraftment was achieved in 23 patients at a median follow-up of 21.2 months (range, 12 days to 234.8 months). Primary graft failure occurred in 1 of 23 patients (4.3%). Neutrophil and platelet engraftment occurred at a median of 16 (range, 12-39) days and 20 (range, 11-78) days, respectively. Acute graft-versus-host disease was seen in 11 of 22 patients engrafted allografts, of which 7 (31.8%) were grade 3-4 acute graft-versus-host disease. Eight patients (36.4%) developed chronic graft-versus-host disease, and three cases were extensive. Four patients (19%) relapsed after a median of 5.5 months, and three patients received donor lymphocyte infusion. The 3-year overall survival rate of the entire study population was 46.2%. The median overall survival was not reached in the myeloablative conditioning group; however, it was 11.9 months in the reduced-intensity conditioning group (p =0.3). According to the donor graft source, the median overall survival was 0.73 months in mismatched unrelated graft recipients, 12 months in matched sibling donors, and not reached in matched unrelated graft recipients (p = 0.03). The 3-year progression-free survival rate of patients who survived > 100 days was 74.7%. The effect of JAK-2 status, graft source, conditioning regimen or dynamic international prognostic scoring system on progression-free survival was not statistically significant. Conclusion: Given the poor prognosis of non-transplant recipients and the lack of non-transplant curative approaches, our results support the consideration of allogeneic hematopoietic stem cell transplantation for eligible patients with primary myelofibrosis.http://www.balkanmedicaljournal.org/text.php?lang=en&id=2482 |
| spellingShingle | Guldane Cengiz Seval Sinem Civriz Bozdag Selami Kocak Toprak Meltem Kurt Yuksel Pervin Topcuoglu Onder Arslan Taner Demirer Gunhan Gurman Meral Beksac Osman Ilhan Muhit Ozcan Allogeneic Hematopoietic Stem Cell Transplantation for Primary Myelofibrosis: A 20-year Experience in a Single Center Balkan Medical Journal |
| title | Allogeneic Hematopoietic Stem Cell Transplantation for Primary Myelofibrosis: A 20-year Experience in a Single Center |
| title_full | Allogeneic Hematopoietic Stem Cell Transplantation for Primary Myelofibrosis: A 20-year Experience in a Single Center |
| title_fullStr | Allogeneic Hematopoietic Stem Cell Transplantation for Primary Myelofibrosis: A 20-year Experience in a Single Center |
| title_full_unstemmed | Allogeneic Hematopoietic Stem Cell Transplantation for Primary Myelofibrosis: A 20-year Experience in a Single Center |
| title_short | Allogeneic Hematopoietic Stem Cell Transplantation for Primary Myelofibrosis: A 20-year Experience in a Single Center |
| title_sort | allogeneic hematopoietic stem cell transplantation for primary myelofibrosis a 20 year experience in a single center |
| url | http://www.balkanmedicaljournal.org/text.php?lang=en&id=2482 |
| work_keys_str_mv | AT guldanecengizseval allogeneichematopoieticstemcelltransplantationforprimarymyelofibrosisa20yearexperienceinasinglecenter AT sinemcivrizbozdag allogeneichematopoieticstemcelltransplantationforprimarymyelofibrosisa20yearexperienceinasinglecenter AT selamikocaktoprak allogeneichematopoieticstemcelltransplantationforprimarymyelofibrosisa20yearexperienceinasinglecenter AT meltemkurtyuksel allogeneichematopoieticstemcelltransplantationforprimarymyelofibrosisa20yearexperienceinasinglecenter AT pervintopcuoglu allogeneichematopoieticstemcelltransplantationforprimarymyelofibrosisa20yearexperienceinasinglecenter AT onderarslan allogeneichematopoieticstemcelltransplantationforprimarymyelofibrosisa20yearexperienceinasinglecenter AT tanerdemirer allogeneichematopoieticstemcelltransplantationforprimarymyelofibrosisa20yearexperienceinasinglecenter AT gunhangurman allogeneichematopoieticstemcelltransplantationforprimarymyelofibrosisa20yearexperienceinasinglecenter AT meralbeksac allogeneichematopoieticstemcelltransplantationforprimarymyelofibrosisa20yearexperienceinasinglecenter AT osmanilhan allogeneichematopoieticstemcelltransplantationforprimarymyelofibrosisa20yearexperienceinasinglecenter AT muhitozcan allogeneichematopoieticstemcelltransplantationforprimarymyelofibrosisa20yearexperienceinasinglecenter |