Allogeneic hematopoietic stem cell transplantation for myelofibrosis

Author:

Deeg H. Joachim1,Gooley Theodore A.1,Flowers Mary E. D.1,Sale George E.1,Slattery John T.1,Anasetti Claudio1,Chauncey Thomas R.1,Doney Kristine1,Georges George E.1,Kiem Hans-Peter1,Martin Paul J.1,Petersdorf Effie W.1,Radich Jerald1,Sanders Jean E.1,Sandmaier Brenda M.1,Warren E. Houston1,Witherspoon Robert P.1,Storb Rainer1,Appelbaum Frederick R.1

Affiliation:

1. From the Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA; and the Seattle VA Medical Center, Seattle, WA.

Abstract

Abstract Fifty-six patients, 10 to 66 years of age, with idiopathic myelofibrosis (IMF) or end-stage polycythemia vera or essential thrombocythemia received allogeneic hematopoietic cell transplants from related (n = 36) or unrelated (n = 20) donors. Forty-four patients were prepared with busulfan plus cyclophosphamide and 12 with total body irradiation plus chemotherapy. The source of stem cells was marrow in 33 and peripheral blood in 23 patients. All but 3 patients achieved engraftment. While 50 patients showed complete donor chimerism, 3 patients were found to be mixed chimeras at 26, 48, and 86 months after transplantation, respectively. Two patients died from relapse/progressive disease, and 18 died from other causes. There are 36 patients surviving at 0.5 to 11.6 (median, 2.8) years, for a 3-year Kaplan-Meier estimate of 58% (CI, 43%-73%). Dupriez score, cytogenetic abnormalities, and degree of marrow fibrosis were the most significant risk factors for posttransplantation mortality. Patients conditioned with a regimen of busulfan targeted to plasma levels of 800 to 900 ng/mL plus cyclophosphamide had a higher probability of survival (76% [CI, 62%-91%]) than other patients. Results with unrelated donors were comparable with those with HLA-identical sibling transplants. Thus, allogeneic hematopoietic cell transplantation offers long-term relapse-free survival for patients with myelofibrosis.

Publisher

American Society of Hematology

Subject

Cell Biology,Hematology,Immunology,Biochemistry

Reference32 articles.

1. Tefferi A. Myelofibrosis with myeloid metaplasia. N Engl J Med.2000;342: 1255-1265.

2. Murphy S, Peterson P, Iland H, Laszlo J. Experience of the Polycythemia Vera Study Group with essential thrombocythemia: a final report on diagnostic criteria, survival, and leukemic transition by treatment. Semin Hematol.1997;34: 29-39.

3. Gruppo Italiano Studio Policitemia. Polycythemia vera: the natural history of 1213 patients followed for 20 years. Ann Intern Med.1995;123: 656-664.

4. Hoffman R. Agnogenic myeloid metaplasia. In: Hoffman R, Benz EJ, Shattil SJ, Furie B, Cohen HJ, Silberstein LE, McGlave P, eds. Hematology: Basice Principles and Practice. New York, NY: Churchill Livingstone; 2000: 1172-1188.

5. Hasselbalch H, Jensen BA. Prognostic factors in idiopathic myelofibrosis: a simple scoring system with prognostic significance. Eur J Haematol.1990;44: 172-178.

Cited by 222 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3