Allogeneic stem cell transplantation as treatment for myelofibrosis

Graft Failure Following Allogeneic Stem Cell Transplantation for Primary Myelofibrosis: A Case Report

“…The incidence of graft failure in myeloablative allo-SCT has been documented to be up to 5% with the majority of patients receiving stem cells from non-identical HLA donors [10,13,14]. A recently published study of 51 patients with 33 having HLA-identical sibling donor and 27 under myeloablative regimen, showed no graft failures [14].…”

“…Conventional medical treatment is unsatisfactory and, with the exception of transfusion therapy, none have been shown to confer a survival benefit [10]. To date, myeloablative allogeneic hematopoietic stem cell transplantation (allo-SCT) remains the only modality with a curative potential for PMF, but has been limited for patients under the age of 60 years and for those with HLA-identical sibling donor because of high transplant-related mortality (TRM) [10,11]. In myeloablative allo-SCT, Guardiola and colleagues [12] reported one graft failure and 1-year TRM of 27%, with a 3-year overall survival of 77% in 55 patients.…”

Relapse of postpolycythemia myelofibrosis after allogeneic stem cell transplantation in a polycythemic phase: successful treatment with donor lymphocyte infusion directed by quantitative PCR test for V617F-JAK2 mutation

“…Its beneficial effect has been further illustrated by successful disease eradication with DLI. 1,2 This case shows the strong antimyelofibrosis effect of DLI that can be separated from GVHD and can be effective even in patients with prior history of acute and/or GVHD. In this case, the GvT effect was demonstrated against the recurrent PV clone.…”

“…It has become the treatment of choice for newly diagnosed patients in chronic phase, and a recent report suggests that modern drug treatment may produce superior results to allogeneic stem cell transplantation (SCT). 1 The imatinib-treated cohort within the International Randomized Study of Interferon and STI571 (IRIS) has provided valuable information on the longer term effects of imatinib treatment. On 400 mg daily, the overall survival at 5 years is 89%.…”

“…1,2 When disease relapses, patients may benefit from donor lymphocyte infusion (DLI) and achieve remission. 3 The accepted mechanism of this therapy is harnessing of the graft-versus-tumor effect (GvT); however, it may be associated with graft-versus-host disease (GVHD) and related morbidity and mortality.…”