Donor types and outcomes of transplantation in myelofibrosis: a CIBMTR study
Recommended Citation
Jain T, Estrada-Merly N, Salas MQ, Kim S, DeVos JD, Chen M, Fang X, Kumar R, Andrade-Campos M, Elmariah H, Agrawal V, Aljurf M, Bacher U, Badar T, Badawy SM, Ballen KK, Beitinjaneh A, Bhatt VR, Bredeson CN, DeFilipp Z, Dholaria B, Farhadfar N, Farhan S, Gandhi A, Ganguly S, Gergis U, Grunwald MR, Hamad N, Hamilton BK, Inamoto Y, Iqbal M, Jamy O, Juckett M, Kharfan-Dabaja MA, Krem MM, Lad DP, Liesveld JL, Al Malki MM, Malone AK, Murthy HS, Ortí G, Patel SS, Pawarode A, Perales MA, van der Poel MWM, Ringden O, Rizzieri DA, Rovo A, Savani BN, Savoie ML, Seo S, Solh MM, Ustun C, Verdonck LF, Wingard JR, Wirk B, Bejanyan N, Jones RJ, Nishihori T, Oran B, Nakamura R, Scott BL, Saber W, and Gupta V. Donor Types and Outcomes of Transplantation in Myelofibrosis: A CIBMTR Study. Blood Adv 2024.
Document Type
Article
Publication Date
8-27-2024
Publication Title
Blood Adv
Abstract
We evaluate the impact of donor types on outcomes of hematopoietic cell transplantation (HCT) in myelofibrosis, using the Center for International Blood and Marrow Transplant Research registry data for HCTs done between 2013 and 2019. In all 1597 patients, the use of haploidentical donors increased from 3% in 2013 to 19% in 2019. In study-eligible 1032 patients who received peripheral blood grafts for chronic-phase myelofibrosis, 38% of recipients of haploidentical HCT were non-White/Caucasian. Matched sibling donor (MSD)-HCTs were associated with superior overall survival (OS) in the first 3 months (haploidentical hazard ratio [HR], 5.80 [95% confidence interval (CI), 2.52-13.35]; matched unrelated (MUD) HR, 4.50 [95% CI, 2.24-9.03]; mismatched unrelated HR, 5.13 [95% CI, 1.44-18.31]; P < .001). This difference in OS aligns with lower graft failure with MSD (haploidentical HR, 6.11 [95% CI, 2.98-12.54]; matched unrelated HR, 2.33 [95% CI, 1.20-4.51]; mismatched unrelated HR, 1.82 [95% CI, 0.58-5.72]). There was no significant difference in OS among haploidentical, MUD, and mismatched unrelated donor HCTs in the first 3 months. Donor type was not associated with differences in OS beyond 3 months after HCT, relapse, disease-free survival, or OS among patients who underwent HCT within 24 months of diagnosis. Patients who experienced graft failure had more advanced disease and commonly used nonmyeloablative conditioning. Although MSD-HCTs were superior, there is no significant difference in HCT outcomes from haploidentical and MUDs. These results establish haploidentical HCT with posttransplantation cyclophosphamide as a viable option in myelofibrosis, especially for ethnic minorities underrepresented in the donor registries.
Medical Subject Headings
Humans; Primary Myelofibrosis; Hematopoietic Stem Cell Transplantation; Male; Female; Middle Aged; Adult; Treatment Outcome; Transplantation Conditioning; Aged; Graft vs Host Disease; Tissue Donors; Registries; Unrelated Donors
PubMed ID
38916866
ePublication
ePub ahead of print
Volume
8
Issue
16
First Page
4281
Last Page
4293
