Splenectomy before allogeneic hematopoietic cell transplantation for myelofibrosis: A French nationwide study
| Autor: | Jean-Baptiste Bossard, Société Francophone de Greffe de Moelle et de Thérapie Cellulaire, Mohamad Mohty, Florence Beckerich, Marie-Thérèse Rubio, Patrice Chevallier, Jérôme Cornillon, Fiorenza Barraco, Federico Garnier, Marie Robin, Alain Duhamel, Gandhi Damaj, Corentin Orvain, Jean-Baptiste Beuscart, Ibrahim Yakoub-Agha, Mathieu Meunier, Thomas Cluzeau, Amandine Charbonnier, Patrice Ceballos, Didier Blaise, Carmen Botella-Garcia, Jean-Jacques Kiladjian, Jacques-Olivier Bay, Tony Marchand |
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| Přispěvatelé: | Role of intra-Clonal Heterogeneity and Leukemic environment in ThErapy Resistance of chronic leukemias (CHELTER), Université Clermont Auvergne (UCA) |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
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medicine.medical_specialty medicine.medical_treatment Splenectomy Hematopoietic stem cell transplantation Disease-Free Survival 03 medical and health sciences 0302 clinical medicine medicine Humans Registries Myelofibrosis Survival rate ComputingMilieux_MISCELLANEOUS business.industry Incidence (epidemiology) Hazard ratio Hematopoietic Stem Cell Transplantation Retrospective cohort study [SDV.MHEP.HEM]Life Sciences [q-bio]/Human health and pathology/Hematology Hematology Middle Aged Allografts medicine.disease 3. Good health Surgery Survival Rate Transplantation surgical procedures operative Primary Myelofibrosis 030220 oncology & carcinogenesis Female France business 030215 immunology |
| Zdroj: | American Journal of Hematology American Journal of Hematology, Wiley, 2021, 96 (1), pp.80-88. ⟨10.1002/ajh.26034⟩ |
| ISSN: | 0361-8609 1096-8652 |
| DOI: | 10.1002/ajh.26034⟩ |
| Popis: | The value of pretransplant splenectomy in patients with myelofibrosis (MF) is subject to debate, since the procedure may preclude subsequent allogeneic hematopoietic cell transplantation (allo-HCT). To determine the impact of pretransplant splenectomy on the incidence of allo-HCT, we conducted a comprehensive retrospective study of all patients with MF for whom an unrelated donor search had been initiated via the French bone marrow transplantation registry (RFGM) between 1 January 2008 and 1 January 2017. Additional data were collected from the patients' medical files and a database held by the French-Language Society for Bone Marrow Transplantation and Cell Therapy (SFGM-TC). We used a multistate model with four states ("RFGM registration"; "splenectomy"; "death before allo-HCT", and "allo-HCT") to evaluate the association between splenectomy and the incidence of allo-HCT. The study included 530 patients from 57 centers. With a median follow-up time of 6 years, we observed 81 splenectomies, 99 deaths before allo-HCT (90 without splenectomy and nine after), and 333 allo-HCTs (268 without splenectomy and 65 after). In a bivariable analysis, the hazard ratio [95% confidence interval (CI)] for the association of splenectomy with allo-HCT was 7.2 [5.1-10.3] in the first 4 months and 1.18 [0.69-2.03] thereafter. The hazard ratio [95% CI] for death associated with splenectomy was 1.58 [0.79-3.14]. These reassuring results suggest that splenectomy does not preclude allo-HCT in patients with MF. |
| Databáze: | OpenAIRE |
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