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Early post-transplantation factors predict survival outcomes in patients undergoing allogeneic hematopoietic cell transplantation for myelofibrosis
Blood Cancer Journal ( IF 12.9 ) Pub Date : 2020-03-10 , DOI: 10.1038/s41408-020-0302-9
Tania Jain 1, 2 , Katie L Kunze 3 , Luke Mountjoy 1 , Daniel K Partain 4, 5 , Heidi Kosiorek 3 , Nandita Khera 1 , William J Hogan 6 , Vivek Roy 7 , James L Slack 1 , Pierre Noel 1 , Veena D S Fauble 8 , Jose F Leis 1 , Lisa Sproat 1 , Ayalew Tefferi 6 , Mrinal M Patnaik 6 , Ruben A Mesa 9 , Jeanne Palmer 1
Affiliation  

Factors predicting allogeneic hematopoietic cell transplantation (HCT) outcomes in myelofibrosis in the early post-HCT period have not been defined thus far. We attempt to study such factors that can help identify patients at a higher risk of relapse or death. This retrospective study included 79 patients who underwent first HCT for myelofibrosis at three centers between 2005 and 2016. Univariate analysis showed that red blood cell (RBC) transfusion dependence (HR 9.02, 95% CI 4.0–20.35), platelet transfusion dependence (HR 8.17, 95%CI 3.83–17.37), 100% donor chimerism in CD33 + cells (HR 0.21, 95%CI 0.07–0.62), unfavorable molecular status (HR 4.41, 95%CI 1.87–10.39), normal spleen size (HR 0.42, 95%CI 0.19–0.94), grade ≥ 2 bone marrow fibrosis (vs. grade ≤ 1; HR 2.7, 95%CI 1.1–6.93) and poor graft function (HR 2.6, 95%CI 1.22–5.53) at day +100 were statistically significantly associated with relapse-free survival (RFS). RBC transfusion dependence and unfavorable molecular status were also statistically significant in the multivariate analysis. Patients in whom both of these factors were present had a significantly worse RFS when compared to those with one or none. While limited by a small sample size, we demonstrate the significance of transfusion dependence and molecular status at day +100 in predicting outcomes.



中文翻译:

早期移植后因素可预测因骨髓纤维化而接受异基因造血细胞移植的患者的生存结果

迄今为止,尚未确定预测 HCT 后早期骨髓纤维化异基因造血细胞移植 (HCT) 结果的因素。我们试图研究这些可以帮助识别复发或死亡风险较高的患者的因素。这项回顾性研究纳入了 2005 年至 2016 年在三个中心因骨髓纤维化接受首次 HCT 的 79 名患者。单变量分析显示红细胞 (RBC) 输血依赖 (HR 9.02, 95% CI 4.0-20.35)、血小板输注依赖 (HR 8.17) , 95%CI 3.83–17.37), CD33 + 细胞中的 100% 供体嵌合 (HR 0.21, 95%CI 0.07–0.62), 不利的分子状态 (HR 4.41, 95%CI 1.87–10.39), 正常脾大小 (0.42HR) , 95%CI 0.19–0.94),≥ 2 级骨髓纤维化(相对于 ≤ 1 级;HR 2.7,95%CI 1.1–6.93)和移植物功能差(HR 2.6,95%CI 1.22–5。53) 在第 +100 天与无复发生存 (RFS) 显着相关。RBC 输血依赖性和不利的分子状态在多变量分析中也具有统计学意义。与同时存在或不存在这两种因素的患者相比,同时存在这两种因素的患者的 RFS 明显更差。虽然受到小样本量的限制,但我们证明了第 +100 天的输血依赖性和分子状态在预测结果中的重要性。

更新日期:2020-04-24
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