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Nabergoj, M.; Mauff, K.; Robin, M.; Kroger, N.; Angelucci, E.; Poire, X.; ... ; Yakoub-Agha, I. (2021)

Outcomes following second allogeneic haematopoietic cell transplantation in patients with myelofibrosis: a retrospective study of the Chronic Malignancies Working Party of EBMT

Article / Letter to editor
Therapeutic management of patients with primary or secondary myelofibrosis (MF) who experience relapse or graft failure following allogeneic haematopoietic cell transplantation (allo-HCT) remains heterogeneous. We retrospectively analyzed 216 patients undergoing a second allo-HCT for either relapse (56%) or graft failure (31%) between 2010 and 2017. Median age was 57.3 years (range 51-63). The same donor as for the first allo-HCT was chosen in 66 patients (31%) of whom 19 received an HLA-identical sibling donor, whereas a different donor was chosen for 116 patients (54%). Median follow-up was 40 months. Three-year overall survival (OS) and relapse-free survival (RFS) were 42% and 39%, respectively. Three-year non-relapse mortality (NRM) and relapse rates were 36% and 25%, respectively. Grade II-IV and III-IV acute GVHD occurred in 25% and 11% of patients, respectively, and the 3-year incidence of chronic GVHD was 33% including 14% for extensive grade. Graft-failure incidence at 1...Show moreTherapeutic management of patients with primary or secondary myelofibrosis (MF) who experience relapse or graft failure following allogeneic haematopoietic cell transplantation (allo-HCT) remains heterogeneous. We retrospectively analyzed 216 patients undergoing a second allo-HCT for either relapse (56%) or graft failure (31%) between 2010 and 2017. Median age was 57.3 years (range 51-63). The same donor as for the first allo-HCT was chosen in 66 patients (31%) of whom 19 received an HLA-identical sibling donor, whereas a different donor was chosen for 116 patients (54%). Median follow-up was 40 months. Three-year overall survival (OS) and relapse-free survival (RFS) were 42% and 39%, respectively. Three-year non-relapse mortality (NRM) and relapse rates were 36% and 25%, respectively. Grade II-IV and III-IV acute GVHD occurred in 25% and 11% of patients, respectively, and the 3-year incidence of chronic GVHD was 33% including 14% for extensive grade. Graft-failure incidence at 1 year was 14%. In conclusion, our data suggest that a second allo-HCT is a potential option for patients failing first allo-HCT for MF albeit careful patient assessment is fundamental to identify individual patients who could benefit from this approach.Show less
All authors
Nabergoj, M.; Mauff, K.; Robin, M.; Kroger, N.; Angelucci, E.; Poire, X.; Passweg, J.; Radujkovic, A.; Platzbecker, U.; Robinson, S.; Rambaldi, A.; Petersen, S.L.; Stolzel, F.; Stelljes, M.; Ciceri, F.; Mayer, J.; Ladetto, M.; Wreede, L.C. de; Koster, L.; Hayden, P.J.; Czerw, T.; Hernandez-Boluda, J.C.; McLornan, D.; Chalandon, Y.; Yakoub-Agha, I.
Date
2021-04-06
Journal
Bone Marrow Transplantation
Volume
56
Issue
8
Pages
1944 - 1952
DOI
doi:10.1038/s41409-021-01271-4