Family mismatched allogeneic stem cell transplantation for Myelofibrosis: Report from the Chronic Malignancies Working Party of EBMT

Article Article scientifique Article Family mismatched allogeneic stem cell transplantation for Myelofibrosis: Report from the Chronic Malignancies Working Party of EBMT eng 2018 author Raj Kavita author Eikema Diderik-Jan author McLornan Donal P author Olavarria Eduardo author Blok Henric-Jan author Bregante Stefania author Ciceri Fabio author Passweg Jakob 632725 author Ljungman Per author Schaap Nicolaas author Carlson Kristina author Zuckerman Tsila author de Wreede Liesbeth C author Volin Liisa author Koc Yener author Diez-Martin J author Brossart Peter author Wolf Dominik author Blaise Didier author Bartolomeo Paolo Di author Vitek Antonin author Robineau Marie 849540 author Yakoub-Agha Ibrahim author Chalandon Yves 644957 author Kroger Nicolaus 10.1016/j.bbmt.2018.10.017 30408564 1083-8791 This analysis includes 56 Myelofibrosis (MF) patients transplanted from family mismatched donor between 2009-2015 enrolled in the European Society for Blood and Marrow Transplantation (EBMT) database. The median age was 57 years (range, 38-72); 75% had primary MF and 25% had secondary MF. JAK2 V617F was mutated in 61%. Donors were HLA mismatched at 2 or more loci. Stem cells were sourced from bone marrow in 66% and peripheral blood in 34%. The median CD34+ cell dose was 4.8 × 106/kg (1.7-22.9 × 106/kg) (n=43). Conditioning was predominantly myeloablative (MAC) in 70% and reduced intensity (RIC) in the remainder. Regimens were heterogeneous with Thiotepa, Busulphan Fludarabine (TBF) and post-transplant cyclophosphamide (PTCy) used in 59%. The incidence of neutrophil engraftment by 28 days was 82% (range, 70-93%), at a median of 21 days (range,19-23). At 2 yrs. the CI of primary Graft failure was 9% (1-16%) and secondary graft failure was 13% (4-22%).The cumulative incidence (CI) of grades II-IV acute GvHD (aGvHD) and III-IV was 28% (16-40%) and 9% (2-17%) at 100 days. The CI of chronic GvHD (cGvHD) at 1 year was 45% (32-58%) but CI of death without cGVHD by 1 year was 20% (10-31%). With a median follow up of 32 months, the 1- and 2-year OS was 61% (48-74%) and 56% (41-70%) respectively. The 1- and 2- year PFS was 58% (45-71%) and 43% (28-58%) with a 2-year CI of relapse of 19% (7-31%). The 2-year non-relapse mortality (NRM) was 38% (24-51%). This retrospective study of MF allo-SCT utilising family mismatched donors, demonstrates feasibility of the approach, timely neutrophil engraftment in over 80% of cases and acceptable OS and PFS rates with relapse rates not dissimilar to the unrelated donor setting. However, strategies to minimise the risk of graft failure and the relatively high NRM need to be employed, ideally in a multicentre prospective fashion. Dewey 616 56 Département de médecine 221 false 1216 Leucémie et transplantation allogénique de cellules souches hématopoïétiques 982 Biology of Blood and Marrow Transplantation 945e88b2-d4ad-40e6-90c8-7eb8fb096c28 Article (Published version) Restricted 1-s2.0-S1083879118306505-main.pdf 654258 application/pdf restrictedAccess Faculté de médecine / Section de médecine clinique / Département de médecine

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Family mismatched allogeneic stem cell transplantation for Myelofibrosis: Report from the Chronic Malignancies Working Party of EBMT	Biology of Blood and Marrow Transplantation			2018	403	0

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Robineau, Marie