TY - JOUR
T1 - A simple prognostic system in patients with myelofibrosis undergoing allogeneic stem cell transplantation
T2 - A CIBMTR/EBMT analysis
AU - Tamari, Roni
AU - McLornan, Donal P
AU - Ahn, Kwang Woo
AU - Estrada-Merly, Noel
AU - Hernandez-Boluda, Juan Carlos
AU - Giralt, Sergio A
AU - Palmer, Jeanne M
AU - Gale, Robert Peter
AU - DeFilipp, Zachariah
AU - Marks, David
AU - van der Poel, Marjolein W M
AU - Verdonck, Leo F
AU - Battiwalla, Minoo
AU - Díaz, Miguel A
AU - Gupta, Vikas
AU - Ali, Haris
AU - Litzow, Mark R
AU - Lazarus, Hillard M
AU - Gergis, Usama
AU - Bashey, Asad
AU - Liesveld, Jane L
AU - Hashmi, Shahrukh
AU - Pu, Jeffrey J
AU - Beitinjaneh, Amer
AU - Bredeson, Christopher N
AU - Rizzieri, David A
AU - Savani, Bipin N
AU - Abid, Muhammad Bilal
AU - Ganguly, Siddhartha
AU - Agrawal, Vaibhav
AU - Ulrike, Vera
AU - Wirk, Baldeep
AU - Jain, Tania
AU - Cutler, Corey S
AU - Aljurf, Mahmoud
AU - Kindwall-Keller, Tamila
AU - Kharfan-Dabaja, Mohamed A
AU - Hildebrandt, Gerhard C
AU - Pawarode, Attaphol
AU - Solh, Melhem M
AU - Yared, Jean A
AU - Grunwald, Michael R
AU - Nathan, Sunita
AU - Nishihori, Taiga
AU - Seo, Sachiko
AU - Scott, Bart L
AU - Nakamura, Ryotaro
AU - Oran, Betul
AU - Czerw, Tomasz
AU - Yakoub-Agha, Ibrahim
AU - Author collaboration
N1 - Copyright © 2023 American Society of Hematology.
PY - 2023/8/8
Y1 - 2023/8/8
N2 - To develop a prognostic model for patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HCT) for myelofibrosis (MF). We examined 623 patients undergoing allo-HCT between 2000 - 2016 in the USA (CIBMTR cohort). A Cox multivariable model was used to identify factors prognostic of mortality. A weighted score using these factors was assigned to patients transplanted in Europe (EBMT cohort) (n = 623). Age above 50 (hazard ratio [HR], 1.39; 95% confidence interval [CI], 0.98 -1.96), and HLA matched unrelated donor (HR, 1.29; 95% CI, 0.98-1.7) were associated with increased hazard of death and were assigned 1 point. Hemoglobin lower than 100g/L at time of transplant (HR, 1.63; 95% CI, 1.2- 2.19), and a mismatched unrelated donor (HR, 1.78; 95% CI, 1.25- 2.52), were assigned 2 points. The 3-year overall survival (OS) in patients with a low (1-2 points), intermediate (3-4 points) and high score (5 points) were 69% (95% CI, 61% -76 %), 51 % (95% CI, 46% -56.4 %), and 34% (95% CI, 21% - 49%), respectively (P. < 0.001). Increasing score was predictive of increased transplant related mortality (TRM) (P .0017) but not for relapse (P. 0.12). The derived score was predictive for OS (P. < 0.001) and TRM (P. 0.002) but not relapse (P. 17) in the EBMT cohort as well. The proposed system was prognostic of survival in two large cohorts, CIBMTR and EBMT, and can easily be applied by clinicians consulting patients with MF on transplant outcomes.
AB - To develop a prognostic model for patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HCT) for myelofibrosis (MF). We examined 623 patients undergoing allo-HCT between 2000 - 2016 in the USA (CIBMTR cohort). A Cox multivariable model was used to identify factors prognostic of mortality. A weighted score using these factors was assigned to patients transplanted in Europe (EBMT cohort) (n = 623). Age above 50 (hazard ratio [HR], 1.39; 95% confidence interval [CI], 0.98 -1.96), and HLA matched unrelated donor (HR, 1.29; 95% CI, 0.98-1.7) were associated with increased hazard of death and were assigned 1 point. Hemoglobin lower than 100g/L at time of transplant (HR, 1.63; 95% CI, 1.2- 2.19), and a mismatched unrelated donor (HR, 1.78; 95% CI, 1.25- 2.52), were assigned 2 points. The 3-year overall survival (OS) in patients with a low (1-2 points), intermediate (3-4 points) and high score (5 points) were 69% (95% CI, 61% -76 %), 51 % (95% CI, 46% -56.4 %), and 34% (95% CI, 21% - 49%), respectively (P. < 0.001). Increasing score was predictive of increased transplant related mortality (TRM) (P .0017) but not for relapse (P. 0.12). The derived score was predictive for OS (P. < 0.001) and TRM (P. 0.002) but not relapse (P. 17) in the EBMT cohort as well. The proposed system was prognostic of survival in two large cohorts, CIBMTR and EBMT, and can easily be applied by clinicians consulting patients with MF on transplant outcomes.
U2 - 10.1182/bloodadvances.2023009886
DO - 10.1182/bloodadvances.2023009886
M3 - Article
C2 - 37134306
SN - 2473-9529
VL - 7
SP - 3993
EP - 4002
JO - Blood advances
JF - Blood advances
IS - 15
ER -