TY - JOUR
T1 - Survival following allogeneic transplant in patients with myelofibrosis
AU - Gowin, Krisstina
AU - Ballen, Karen
AU - Ahn, Kwang Woo
AU - Hu, Zhen Huan
AU - Ali, Haris
AU - Arcasoy, Murat O.
AU - Devlin, Rebecca
AU - Coakley, Maria
AU - Gerds, Aaron T.
AU - Green, Michael
AU - Gupta, Vikas
AU - Hobbs, Gabriela
AU - Jain, Tania
AU - Kandarpa, Malathi
AU - Komrokji, Rami
AU - Kuykendall, Andrew T.
AU - Luber, Kierstin
AU - Masarova, Lucia
AU - Michaelis, Laura C.
AU - Patches, Sarah
AU - Pariser, Ashley C.
AU - Rampal, Raajit
AU - Stein, Brady
AU - Talpaz, Moshe
AU - Verstovsek, Srdan
AU - Wadleigh, Martha
AU - Agrawal, Vaibhav
AU - Aljurf, Mahmoud
AU - Diaz, Miguel Angel
AU - Avalos, Belinda R.
AU - Bacher, Ulrike
AU - Bashey, Asad
AU - Beitinjaneh, Amer M.
AU - Cerny, Jan
AU - Chhabra, Saurabh
AU - Copelan, Edward
AU - Cutler, Corey S.
AU - DeFilipp, Zachariah
AU - Gadalla, Shahinaz M.
AU - Ganguly, Siddhartha
AU - Grunwald, Michael R.
AU - Hashmi, Shahrukh K.
AU - Kharfan-Dabaja, Mohamed A.
AU - Kindwall-Keller, Tamila
AU - Kröger, Nicolaus
AU - Lazarus, Hillard M.
AU - Liesveld, Jane L.
AU - Litzow, Mark R.
AU - Marks, David I.
AU - Nathan, Sunita
AU - Nishihori, Taiga
AU - Olsson, Richard F.
AU - Pawarode, Attaphol
AU - Rowe, Jacob M.
AU - Savani, Bipin N.
AU - Savoie, Mary Lynn
AU - Seo, Sachiko
AU - Solh, Melhem
AU - Tamari, Roni
AU - Verdonck, Leo F.
AU - Yared, Jean A.
AU - Alyea, Edwin
AU - Popat, Uday
AU - Sobecks, Ronald
AU - Scott, Bart L.
AU - Nakamura, Ryotaro
AU - Mesa, Ruben
AU - Saber, Wael
N1 - Funding Information:
The CIBMTR is supported primarily by Public Health Service grant/cooperative agreement U24CA076518 with the National Institutes of Health (NIH), National Cancer Institute (NCI); National Heart, Lung, and Blood Institute (NHLBI); and National Institute of Allergy and Infectious Diseases (NHLBI and NCI grant/cooperative agreement U24HL138660; NHLBI grants OT3HL147741, R21HL140314, and U01HL128568; Health Resources and Services Administration [HRSA] contract HHSH250201700006C; Office of Naval Research grants N00014-18-1-2888 and N00014-17-1-2850; HRSA subaward from prime contract award SC1MC31881-01-00; NHLBI subawards from prime grant awards R01HL131731 and R01HL126589; NIH subawards from prime grant awards 5P01CA111412, 5R01HL129472, R01CA152108, 1R01HL131731, 1U01AI126612, and 1R01CA231141) and commercial funds from Actinium Pharmaceuticals, Adaptive Biotechnologies, Allovir, Amgen, and anonymous donation to the Medical College of Wisconsin, Anthem, Astellas Pharma US, Atara Biotherapeutics, BARDA, Be the Match Foundation, bluebird bio, Boston Children’s Hospital, Bristol Myers Squibb, Celgene, Children’s Hospital of Los Angeles, Chimerix, City of Hope Medical Center, CSL Behring, CytoSen Therapeutics, Inc., Daiichi Sankyo, Dana Farber Cancer Institute, Enterprise Science and Computing, Fred Hutchinson Cancer Research Center, Gamida-Cell, Genzyme, Gilead Sciences, GlaxoSmithKline, HistoGenetics, Immucor, Incyte Corporation, Janssen Biotech, Janssen Pharmaceuticals, Janssen Research & Development, Janssen Scientific Affairs, Japan Hematopoietic Cell Transplantation Data Center, Jazz Pharmaceuticals, Karius, Karyopharm Therapeutics, Kite (a Gilead Company), Kyowa Kirin, Magenta Therapeutics, Mayo Clinic and Foundation Rochester, Medac GmbH, Mediware, Memorial Sloan Kettering Cancer Center, Merck & Company, Mesoblast, MesoScale Diagnostics, Millennium, the Takeda Oncology Co., Miltenyi Biotec, Mundipharma EDO, National Marrow Donor Program, Novartis Oncology, Novartis Pharmaceuticals Corporation, Omeros Corporation, Oncoimmune, OptumHealth, Orca Bio-systems, PCORI, Pfizer, Phamacyclics, PIRCHE AG, Regen-eron Pharmaceuticals, REGiMMUNE, Sanofi Genzyme, Seattle Genetics, Shire, Sobi, Spectrum Pharmaceuticals, St. Baldrick’s Foundation, Swedish Orphan Biovitrum, Takeda Oncology, The Medical College of Wisconsin, University of Minnesota, University of Pittsburgh, University of Texas MD Anderson Cancer Center, University of Wisconsin-Madison, Viracor Eurofins, and Xenikos BV.
Funding Information:
Conflict-of-interest disclosure: A.T.K. received research funding from Incyte, AbbVie, Janssen, and Colgene. A.T.G. received research funding from Celgene, Incyte, CTI Biopharma, and Pfizer. G.H. received research funding from Bayer, Meirck, Incyte, and Celgene. R.F.O. received research funding from AstraZeneca. Z.D. received research funding from Incyte Corp. M.O.A. received research funding from Incyte, Gilead, Samus Therapeautics, CTI Biopharma, and Janssen. B.R.A. contributed to Best Practice guidelines for the British Med J and received research funding from Juno. V.G. received research funding from Novartis, Celgene, Sierra Oncology, and Incyte. L.C.M. received research funding from ASTEX, Bioline, BMS, Celgene, Janssen, Jazz, Macrogenics, Millennium, Novartis, Pfizer, and TG Therapeutics. J.C. received research funding from Inctye, Daichi-Sankyo, and Jaze Pharmaceuticals. K.G. received consultancy fees from and is a member of the scientific advisory board for Incyte Corporation. R.N. received research funding from Alexion, Celgene, Kirin Kyowa, and Merck. M.T. received research funding from Celgene, CTI Biopharma, Imago, and Constellation. S.V. received research funding from Incyte Corporation, Roche, NS Pharma, Celgene, Gilead, Promisor, CTI BioPharma, Genentech, Blueprint Medicines, Novartis, Sierra Oncology, Pharma Essentia, AstraZeneca, Ital Pharma, and Protagonist Therapeutics. M.G. received consultancy fees from Incyte, Amgen, AbbVie, Astellas, BMS/Celgene, Merck, Pfizer, Premier,
Publisher Copyright:
© 2020 American Society of Hematology. All rights reserved.
PY - 2020/5/12
Y1 - 2020/5/12
N2 - Allogeneic hematopoietic cell transplantation (HCT) is the only curative therapy for myelofibrosis (MF). In this large multicenter retrospective study, overall survival (OS) in MF patients treated with allogeneic HCT (551 patients) and without HCT (non-HCT) (1377 patients) was analyzed with Cox proportional hazards model. Survival analysis stratified by the Dynamic International Prognostic Scoring System (DIPSS) revealed that the first year of treatment arm assignment, due to upfront risk of transplant-related mortality (TRM), HCT was associated with inferior OS compared with non-HCT (non-HCT vs HCT: DIPSS intermediate 1 [Int-1]: hazard ratio [HR] 5 0.26, P, .0001; DIPSS-Int-2 and higher: HR, 0.39, P, .0001). Similarly, in the DIPSS low-risk MF group, due to upfront TRM risk, OS was superior with non-HCT therapies compared with HCT in the first-year post treatment arm assignment (HR, 0.16, P 5 .006). However, after 1 year, OS was not significantly different (HR, 1.38, P 5 .451). Beyond 1 year of treatment arm assignment, an OS advantage with HCT therapy in Int-1 and higher DIPSS score patients was observed (non-HCT vs HCT: DIPSS-Int-1: HR, 2.64, P, .0001; DIPSS-Int-2 and higher: HR, 2.55, P, .0001). In conclusion, long-term OS advantage with HCT was observed for patients with Int-1 or higher risk MF, but at the cost of early TRM. The magnitude of OS benefit with HCT increased as DIPSS risk score increased and became apparent with longer follow-up.
AB - Allogeneic hematopoietic cell transplantation (HCT) is the only curative therapy for myelofibrosis (MF). In this large multicenter retrospective study, overall survival (OS) in MF patients treated with allogeneic HCT (551 patients) and without HCT (non-HCT) (1377 patients) was analyzed with Cox proportional hazards model. Survival analysis stratified by the Dynamic International Prognostic Scoring System (DIPSS) revealed that the first year of treatment arm assignment, due to upfront risk of transplant-related mortality (TRM), HCT was associated with inferior OS compared with non-HCT (non-HCT vs HCT: DIPSS intermediate 1 [Int-1]: hazard ratio [HR] 5 0.26, P, .0001; DIPSS-Int-2 and higher: HR, 0.39, P, .0001). Similarly, in the DIPSS low-risk MF group, due to upfront TRM risk, OS was superior with non-HCT therapies compared with HCT in the first-year post treatment arm assignment (HR, 0.16, P 5 .006). However, after 1 year, OS was not significantly different (HR, 1.38, P 5 .451). Beyond 1 year of treatment arm assignment, an OS advantage with HCT therapy in Int-1 and higher DIPSS score patients was observed (non-HCT vs HCT: DIPSS-Int-1: HR, 2.64, P, .0001; DIPSS-Int-2 and higher: HR, 2.55, P, .0001). In conclusion, long-term OS advantage with HCT was observed for patients with Int-1 or higher risk MF, but at the cost of early TRM. The magnitude of OS benefit with HCT increased as DIPSS risk score increased and became apparent with longer follow-up.
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U2 - 10.1182/bloodadvances.2019001084
DO - 10.1182/bloodadvances.2019001084
M3 - Article
C2 - 32384540
AN - SCOPUS:85086108920
VL - 4
SP - 1966
EP - 1973
JO - Blood advances
JF - Blood advances
SN - 2473-9529
IS - 9
ER -