Australasian Trends in Allogeneic Stem Cell Transplantation for Myelofibrosis in the Molecular Era: A Retrospective Analysis from the Australasian Bone Marrow Transplant Recipient Registry

Lwin, Yadanar; Kennedy, Glenn; Gottlieb, David; Kwan, John; Ritchie, David; Szer, Jeff; Milliken, Samuel; Browett, Peter; Spencer, Andrew; Butler, Andrew; Bardy, Peter; Greenwood, Matthew; Perera, Travis; He, Simon; McEwan, Ashley; Larsen, Stephen; Lai, Hock Choong; Purtill, Duncan; Tran, Steven; Aarons, Donna; Hamad, Nada

doi:10.1016/j.bbmt.2020.08.024

Cited by 8 publications

(9 citation statements)

References 39 publications

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“…Despite improving OS trends for transplantation, there has been relatively little change in MF HCT outcomes. 12 This is reflected in a recent Australasian retrospective analysis comparing outcomes of a recent cohort to an earlier group from 1993 to 2005. The 5‐year OS was 57% and to 53%, respectively.…”

Section: Targets For Improved Transplant Outcomes For Mfmentioning

confidence: 99%

“…The 5‐year OS was 57% and to 53%, respectively. 12 CIBMTR data indicates 3‐year OS in all acute myeloid leukemia (AML) is 53%, 48% for myelodysplastic syndrome (MDS) and 55%–65% for the matched related MF subset. 25 While NRM posttransplant for AML is around 20% at 5 years, it is 18%–25% at only 1 year, 12 , 26 , 27 and around 35% at 5 years in MF.…”

Section: Targets For Improved Transplant Outcomes For Mfmentioning

confidence: 99%

“… 12 CIBMTR data indicates 3‐year OS in all acute myeloid leukemia (AML) is 53%, 48% for myelodysplastic syndrome (MDS) and 55%–65% for the matched related MF subset. 25 While NRM posttransplant for AML is around 20% at 5 years, it is 18%–25% at only 1 year, 12 , 26 , 27 and around 35% at 5 years in MF. 28 A recent large retrospective analysis documented a high mortality in the first 12 months posttransplant, followed by a plateau in OS, with high variability in survival stratified by DIPSS.…”

Section: Targets For Improved Transplant Outcomes For Mfmentioning

confidence: 99%

“…Current evidence pertains to superseded prognostic models. 11 , 12 , 14 , 24 The DIPSS incorporates age, constitutional symptoms, anemia, leukocytosis, and peripheral blast count. 7 When applied to the transplant setting, high scores unsurprisingly portend increased relapse rate (RR), reduced progression‐free survival (PFS), and less GVHD‐free and relapse‐free survival.…”

Section: Nrm : Contributing Factors and Potential Strategies...mentioning

confidence: 99%

“… 7 , 8 The only potentially curative treatment is allogeneic hematopoietic stem cell transplantation (HCT), with prospective studies 9 , 10 and multiple retrospective analyses confirming a long term survival advantage of HCT compared to nontransplant therapy. 11 , 12 …”

Section: Introductionmentioning

confidence: 99%

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Innovative strategies to improve hematopoietic stem cell transplant outcomes in myelofibrosis

et al. 2022

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Myelofibrosis (MF) is a clonal myeloproliferative neoplasm characterized by inflammation, marrow fibrosis, and an inherent risk of blastic transformation. Hematopoietic allogeneic stem cell transplant is the only potentially curative therapy for this disease, however, survival gains observed for other transplant indications over the past two decades have not been realized for MF. The role of transplantation may also evolve with the use of novel targeted agents. The chronic inflammatory state associated with MF necessitates pretransplantation assessment of end-organ function. Applying the transplant methodology employed for other myeloid disorders to patients with MF fails to acknowledge differences in the underlying disease pathophysiology. Limited understanding of the causes of poor transplant outcomes in this cohort has prevented refinement of transplant eligibility criteria in MF. There is increasing evidence of heterogeneity in molecular disease grade, beyond the clinical manifestations which have traditionally guided transplant timing. Exploring the physiological consequences of disease chronicity unique to MF, acknowledging the heterogeneity in disease grade, and using advanced prognostic models, molecular diagnostics and other organ function diagnostic tools, we present an innovative review of strategies with the potential to improve transplant outcomes in this disease. Larger, prospective studies which consider the impact of molecular-based disease grade are needed for MF transplantation.

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Section: Targets For Improved Transplant Outcomes For Mfmentioning

confidence: 99%