Outcomes after allogeneic hematopoietic cell transplant in patients diagnosed with blast phase of myeloproliferative neoplasms: A retrospective study from the Chronic Malignancies Working Party of the European Society for Blood and Marrow Transplantation

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Guillermo Ortí - , Vall d'Hebron University Hospital (Author)
  • Luuk Gras - , EBMT Statistical Unit (Author)
  • Nienke Zinger - , EBMT Leiden Study Unit (Author)
  • Maria Chiara Finazzi - , University of Milan, ASST Papa Giovanni XXIII Hospital (Author)
  • Katja Sockel - , Department of Internal Medicine I, Department of internal Medicine I (Author)
  • Marie Robin - , Hôpital Saint-Louis (Author)
  • Edouard Forcade - , Service d'Hématologie Clinique et Thérapie Cellulaire (Author)
  • Daniele Avenoso - , Kings College Hospital NHS Foundation Trust (Author)
  • Nicolaus Kröger - , University Hospital Hamburg Eppendorf (Author)
  • Jürgen Finke - , Protestant University of Applied Sciences Freiburg (Author)
  • Aleksandar Radujkovic - , National Center for Tumor Diseases (NCT) Heidelberg (Author)
  • Mathilde Hunault-Berger - , University Hospital of Lille (Author)
  • Wilfried Schroyens - , Antwerp University Hospital (UZA) (Author)
  • Tsila Zuckerman - , Rambam Medical Center (Author)
  • Jean Henri Bourhis - , Institut Gustave Roussy (Author)
  • Yves Chalandon - , Geneva University Hospitals (Author)
  • Adrian Bloor - , The Christie NHS Foundation Trust (Author)
  • Rik Schots - , Universitair Ziekenhuis (UZ) Brussel (Author)
  • Liesbeth C de Wreede - , Leiden University (Author)
  • Joana Drozd-Sokolowska - , University Clinical Centre of the Republic of Srpska (Author)
  • Kavita Raj - , University College London Hospitals NHS Foundation Trust (Author)
  • Nicola Polverelli - , USD Trapianti di Midollo (Author)
  • Tomasz Czerw - , Maria Sklodowska-Curie Institute of Oncology (Author)
  • Juan Carlos Hernández-Boluda - , University Clinical Hospital of Santiago de Compostela (Author)
  • Donal McLornan - , University College London Hospitals NHS Foundation Trust (Author)
  • Ibrahim Yakoub-Agha - , University Hospital of Lille (Author)

Abstract

Allogeneic hematopoietic cell transplant (allo-HCT) provides the only potential route to long-term remission in patients diagnosed with blast phase transformation of myeloproliferative neoplasm (BP-MPN). We report on a large, retrospective European Society for Blood and Marrow Transplantation registry-based study of BP-MPN patients undergoing allo-HCT. BP-MPN patients undergoing first allo-HCT between 2005 and 2019 were included. A total of 663 patients were included. With a median follow-up of 62 months, the estimated 3-year overall survival (OS) was 36% (95% confidence interval [CI], 32-36). Factors associated with lower OS were Karnofsky Performance Score (KPS) <90 (hazard ratio [HR] 1.65, p < .001) and active disease at allo-HCT (HR 1.45, p < .001), whereas patients undergoing allo-HCT more recently associated with a higher OS (HR 0.96, p = .008). In a selected patient's population, the 3-year OS of patients undergoing allo-HCT in complete response (CR) and with a KPS ≥90 was 60%. KPS < 90 (HR 1.4, p = .001) and active disease (HR 1.44, p = .0004) were associated with a lower progression-free survival (PFS). Conversely, most recent allo-HCT associated with a higher PFS (HR 0.96, p = .008). Active disease at allo-HCT (HR 1.34, p = .03) was associated with a higher cumulative incidence of relapse (RI) and allo-HCT in earlier calendar years (HR 0.96, p = .02) associated with a lower RI. Last, KPS < 90 (HR 1.91, p < .001), active disease (HR 1.74, p = .003) and allo-HCT from mismatched related donors were associated with a higher non-relapse mortality (HR 2.66, p = .003). In this large series of BP-MPN patients, about one third were alive at 3 years after transplantation. Patients undergoing allo-HCT in the more recent era, with a KPS ≥90 and in CR at transplant had a better prognosis.

Details

Original languageEnglish
Pages (from-to)628-638
Number of pages11
JournalAmerican journal of hematology
Volume98
Issue number4
Publication statusPublished - Apr 2023
Peer-reviewedYes

External IDs

Scopus 85146337010

Keywords

Keywords

  • Humans, Retrospective Studies, Hematopoietic Stem Cell Transplantation/adverse effects, Transplantation, Homologous/adverse effects, Blast Crisis/therapy, Bone Marrow, Neoplasm Recurrence, Local/etiology, Myeloproliferative Disorders/therapy, Transplantation Conditioning