Allogeneic stem cell transplantation for myelofibrosis patients aged ≥65 years. (5th August 2019)

• Record Type: Journal Article
• Authors: Daghia, Giulia; Zabelina, Tatjana; Zeck, Gaby; von Pein, Ute‐Marie; Christopeit, Maximilian; Wolschke, Christine; Ayuk, Francis; Kröger, Nicolaus
• Is Part Of: European journal of haematology. Volume 103:Number 4(2019)
• Page Start: 370
• Page End: 378
• Publication Date: 2019-08-05
• Subjects: allogeneic stem cell transplantation -- myelofibrosis -- older patients -- reduced intensity conditioning -- Sorror index; Hematology -- Periodicals; Blood -- Diseases -- Periodicals; Blood -- Periodicals; 616.15005
• DOI: 10.1111/ejh.13294
• Languages: English
• ISSNs: 0902-4441

Abstract

Abstract: 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.