Hematopoietic Cell Transplantation for Myelofibrosis: the Dynamic International Prognostic Scoring System Plus Risk Predicts Post-Transplant Outcomes
| Autor: | Michael L. Linenberger, Rachel B. Salit, Effie W. Petersdorf, Min Fang, Mohamed L. Sorror, David Wu, Barry E. Storer, Cecilia Yeung, H. Joachim Deeg, Janghee Woo, Emily A. Stevens, Brenda M. Sandmaier, Bart L. Scott, Bethany T. Samuelson Bannow, Kris Doney |
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| Rok vydání: | 2018 |
| Předmět: |
Oncology
Transplantation medicine.medical_specialty Multivariate analysis Hematopoietic cell business.industry Incidence (epidemiology) Hematology medicine.disease Post transplant Surgery 03 medical and health sciences 0302 clinical medicine International Prognostic Scoring System 030220 oncology & carcinogenesis Internal medicine medicine Overall survival Myelofibrosis business 030215 immunology |
| Zdroj: | Biology of Blood and Marrow Transplantation. 24:386-392 |
| ISSN: | 1083-8791 |
| DOI: | 10.1016/j.bbmt.2017.09.016 |
| Popis: | Hematopoietic cell transplantation (HCT) provides potentially curative treatment for patients with myelofibrosis (MF). HCT outcomes are associated with the Dynamic International Prognostic Scoring System (DIPSS) risk scores. In the present study we analyzed results in 233 patients to determine if the DIPSS plus classification, which adds cytogenetics, thrombocytopenia, and RBC transfusion dependence as risk factors, would better predict post-HCT outcomes than the original DIPSS. Multivariate analysis showed that each risk parameter incorporated into the DIPPS plus model contributed to its predictive power of overall mortality, relapse-free survival, and nonrelapse mortality. The 5-year overall survival (OS), relapse, and treatment-related mortality (TRM) rates for patients with low/intermediate-1 risk MF were 78%, 5%, and 20%, respectively. The 5-year OS, relapse, and TRM rates for patients with high-risk MF were 35%, 28%, and 40%, respectively. The HCT-specific comorbidity index of 3 or greater was associated with higher nonrelapse and overall mortality and reduced relapse-free survival. The relapse incidence was significantly increased in older patients (HR, 3.02; P = .0007). With a median follow-up of 8 years 124 patients (53%) were surviving. The components of the DIPSS plus classification still have prognostic relevance after adjustment by the DIPSS classification. This information should enhance our ability to advise patients when making decisions regarding timing of transplant. |
| Databáze: | OpenAIRE |
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